| NPI | 1043403918 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHEL MIER GRUNER Owner 225-658-5959 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA 024988) |
| Additional Taxonomies | 208600000X Surgery (Licence: LA 023672) |
| Enumeration Date | 2007-08-23 |
| Last Update Date | 2007-08-23 |