| NPI | 1780214056 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVERARDO SERGIO GARCIA Managing Provider 505-393-7493 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2020-01-24 |
| Last Update Date | 2023-01-18 |