NPI | 1003285255 |
---|---|
Entity Type | Organization |
Authorized Contact | GREG J GAVIN Network Administrator 318-212-8780 |
Organization Subpart ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology |
Enumeration Date | 2015-09-17 |
Last Update Date | 2015-09-18 |