| NPI | 1205160181 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTIAN A MAYORGA Member 504-305-0063 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: LA 11181R) |
| Enumeration Date | 2009-09-25 |
| Last Update Date | 2011-10-25 |