NPI | 1780233833 |
---|---|
Entity Type | Organization |
Authorized Contact | MICHELLE ROLANDE BUTCHER Credentialing Administrator & Msa 505-828-4923 |
Organization Subpart ? | No |
Primary Taxonomy | 207W00000X Ophthalmology |
Additional Taxonomies | 152W00000X Optometrist |
Enumeration Date | 2019-09-10 |
Last Update Date | 2019-09-10 |