| NPI | 1366783268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MYTHE LARAMIE Co Owner 559-435-0339 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA G59244) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA G38222) |
| Enumeration Date | 2013-03-03 |
| Last Update Date | 2023-06-06 |