NPI | 1356621593 |
---|---|
Entity Type | Organization |
Authorized Contact | WARREN L DAZZIO Managing Director 225-922-7700 |
Organization Subpart ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA RN108288AP04367) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA 757023266) |
Enumeration Date | 2011-08-19 |
Last Update Date | 2011-08-19 |