| NPI | 1134565112 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN EDWARD ZGANJAR Owner/Md 225-933-0090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: LA 022406) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: LA AP07255) |
| Enumeration Date | 2013-05-16 |
| Last Update Date | 2013-05-16 |