| NPI | 1770312100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER A DIAZ Co Owner 915-209-0233 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2024-08-01 |
| Last Update Date | 2024-10-03 |