| NPI | 1609199447 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE ROSALES Owner 575-532-5386 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NM CNP00942) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: TX DT06119) |
| 133V00000X Dietitian, Registered (Licence: NM LD0748) | |
| Enumeration Date | 2010-03-08 |
| Last Update Date | 2013-03-29 |