Facts
- Status
- A
- Credential
- MD
- Type
- Individual
- Enumeration date
- 2006-03-15
- Last updated
- 2012-07-16
Licenses
- License NM
- 81148
Location
- Practice location
- 201 CEDAR SE #405
- City
- ALB NM
- Postal code
- 87106
- Phone
- 505-764-9535
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
The OIG NPI list is not in this build yet. Confirm on OIG's search.
Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.