| NPI | 1952941114 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHERINE ROSACKER-SHARP Administrator 505-450-8709 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2020-01-15 |
| Last Update Date | 2022-05-24 |