NPI | 1336470574 |
---|---|
Entity Type | Organization |
Authorized Contact | GREG J. GAVIN Network Administrator 318-424-4232 |
Organization Subpart ? | No |
Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology |
Additional Taxonomies | 207T00000X Neurological Surgery |
Enumeration Date | 2010-01-28 |
Last Update Date | 2021-07-21 |