| NPI | 1770640500 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARLYN A GANSEL ANG Managing Partner 505-332-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NM OP2-299) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2012-10-03 |