| NPI | 1396099032 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWIN JOHN MILTENBERGER Owner 985-222-2002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP06943) |
| Enumeration Date | 2012-11-02 |
| Last Update Date | 2012-11-02 |