| NPI | 1972713816 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATRINA M FERRALES Credentialing Specialist 575-647-8366 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NM 2005-0482) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2008-05-06 |