| NPI | 1639726920 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLGA LUCERO President 505-450-4478 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 207N00000X Dermatology |
| Enumeration Date | 2019-08-21 |
| Last Update Date | 2023-09-05 |