| NPI | 1902112956 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA LIZA ROMERO Physician 505-924-1895 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: NM 03195795001) |
| Enumeration Date | 2010-08-27 |
| Last Update Date | 2019-01-10 |