| NPI | 1982922696 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YOLANDA CARRILLO Coordinator 505-426-2564 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS1000X Clinic/Center, Student Health (Licence: NM 261QS1000X) |
| Enumeration Date | 2010-05-06 |
| Last Update Date | 2010-05-06 |