| NPI | 1265752026 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAHIHEE JACKSON Assist Manager 985-893-1070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA 022131) |
| Enumeration Date | 2010-06-03 |
| Last Update Date | 2010-06-03 |