NPI | 1053557124 |
---|---|
Entity Type | Organization |
Authorized Contact | LINDA MARIAN YARRIS-EWERT Physician/Owner 239-274-2071 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL 0064852) |
Enumeration Date | 2008-12-19 |
Last Update Date | 2009-01-07 |