| NPI | 1851374433 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLOTTE MCGAUGHEY Administrator 505-388-1242 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM 97374) |
| Enumeration Date | 2005-11-28 |
| Last Update Date | 2020-08-22 |