| NPI | 1366156606 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH YAW Pa/Co Owner 605-318-8494 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207P00000X Emergency Medicine |
| Enumeration Date | 2023-01-11 |
| Last Update Date | 2023-01-11 |