| NPI | 1629296595 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN DAMIAN FOGARTY President 505-470-8686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM NM 95-54) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM NM 98-18) |
| 207RI0200X Internal Medicine Infectious Disease (Licence: NM NM 98-18) | |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2020-08-22 |