| NPI | 1588200836 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRITTANY LEIGH VICK Credentialing Specialist 505-485-0464 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0005X Clinic/Center, Ambulatory Family Planning Facility |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology |
| Enumeration Date | 2019-11-21 |
| Last Update Date | 2020-07-30 |