| NPI | 1013432616 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT LUKE SANSOVICH President 985-789-2534 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2017-08-04 |
| Last Update Date | 2022-07-21 |