| NPI | 1831284967 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TWANA LIVETTE SPARKS President 505-538-0486 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: NM 87-386nm) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2020-08-22 |