| NPI | 1083332845 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TACCARA ROSS Office Manager 225-803-7877 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 291U00000X Clinical Medical Laboratory | |
| Enumeration Date | 2022-08-18 |
| Last Update Date | 2024-08-28 |