| NPI | 1881998664 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARVEL ELIZABETH HARRISON Office Manager 505-412-3367 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NM 93244) |
| Enumeration Date | 2011-01-07 |
| Last Update Date | 2011-01-07 |