| NPI | 1073777843 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PURNACHANDRA R YERNENI Owner/President 985-732-9930 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: LA 10096R) |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2008-07-10 |