| NPI | 1003479387 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEAU PORCHE Authorized Official/Owner 985-873-8586 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine |
| Additional Taxonomies | 207L00000X Anesthesiology |
| Enumeration Date | 2019-04-22 |
| Last Update Date | 2020-03-25 |