| NPI | 1952293466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIDA FATEMI Practitioner 505-272-3120 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2025-07-18 |
| Last Update Date | 2025-10-07 |