| NPI | 1790197614 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GONZALO CORONA-GONZALEZ Physican 575-578-4815 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: NM MD2007-0650) |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2014-05-27 |