Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Sleep Disorder Diagnostic |
261QS1200X | |||
Sleep Medicine |
207RS0012X | 11 | Physician/Internal Medicine |
| NPI Number | 1679110530 |
||||
| LBN Legal business name | NEW MEXICO SLEEP LABS | ||||
| Authorized official | GONZALO DIAZ - (OWNER) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | Yes | ||||
| Enumeration date | 12/10/2019 | ||||
| Last updated | 03/24/2022 - About 4 years ago | ||||
| Identifiers |
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