| NPI | 1912936774 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM E LAFRENIERE Billing Manager 575-532-1888 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X (Licence: NM 84-180) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NM 84-180) |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2017-11-15 |