| NPI | 1912039173 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY DIMMETTE Owner 505-425-3414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: NM NM96227) |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2020-08-22 |