| NPI | 1821189101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADDY BHASKER Administrator 575-835-2940 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2015-09-09 |