NPI | 1477230928 |
---|---|
Entity Type | Organization |
Authorized Contact | ERIC YECIES Cco 800-852-1575 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X Clinic/Center |
Additional Taxonomies | 207K00000X Allergy & Immunology |
207Q00000X Family Medicine | |
207R00000X Internal Medicine | |
363L00000X Nurse Practitioner | |
Enumeration Date | 2023-06-28 |
Last Update Date | 2024-05-28 |