NPI | 1255941324 |
---|---|
Entity Type | Organization |
Authorized Contact | LISHA C FALK VP Of Contracting 337-609-1221 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine |
Additional Taxonomies | 363A00000X Physician Assistant |
363L00000X Nurse Practitioner | |
Enumeration Date | 2020-08-04 |
Last Update Date | 2022-03-23 |