| NPI | 1417289711 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARITA DAVIS ACKLIN Administrator 225-382-3920 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: LA AP05942) |
| Additional Taxonomies | 170100000X Medical Genetics, Ph.D. Medical Genetics (Licence: LA MD021278) |
| Enumeration Date | 2010-02-11 |
| Last Update Date | 2010-02-11 |