| NPI | 1932645579 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA NICHOLE GUTIERREZ Owner 505-358-8468 |
| Organization Subpart ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM 2016342231) |
| Enumeration Date | 2017-01-06 |
| Last Update Date | 2017-01-06 |