| NPI | 1104353739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FERNANDO LUIS HERNANDEZ CEO 985-570-3012 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP08485) |
| Enumeration Date | 2017-05-14 |
| Last Update Date | 2022-07-21 |