| NPI | 1285967943 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IPHOGENIER BARRY President 601-981-7198 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS R733308) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS R718637) |
| Enumeration Date | 2009-09-14 |
| Last Update Date | 2009-09-14 |