| NPI | 1912061235 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEKSANDR GAZAROV Owner,President 575-589-2025 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NM MD2004-0757) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: NM MD2004-0757) |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2013-11-04 |