NPI | 1578015012 |
---|---|
Entity Type | Organization |
Authorized Contact | JEFF MCWHORTER CFO 575-779-1007 |
Organization Subpart ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NM MD-2011-0547) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM MD-2011-0547) |
Enumeration Date | 2016-11-01 |
Last Update Date | 2019-01-10 |