| 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 |