| NPI | 1962992255 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELANIE UKANWA Medical Director 505-658-1392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| 207R00000X Internal Medicine | |
| 207P00000X Emergency Medicine | |
| Enumeration Date | 2018-05-14 |
| Last Update Date | 2018-05-14 |