NPI | 1992132500 |
---|---|
Entity Type | Organization |
Authorized Contact | FRANK J DIMOTTA Provider Owner 575-630-1214 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM 2000-25) |
Enumeration Date | 2013-09-27 |
Last Update Date | 2013-09-27 |