| NPI | 1932562360 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLEN KIM Sole Member/Physician 505-506-1984 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: NM 97-289) |
| Enumeration Date | 2016-04-02 |
| Last Update Date | 2016-04-02 |