| NPI | 1730259805 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA JETER Practice Manager 505-875-1583 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine |
| Additional Taxonomies | 2471C3402X Radiologic Technologist, Radiography |
| 2471S1302X Radiologic Technologist, Sonography | |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2019-08-26 |