| NPI | 1023074549 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREG J. GAVIN Network Administrator 318-212-3868 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine |
| Enumeration Date | 2006-04-24 |
| Last Update Date | 2018-05-09 |