| NPI | 1457176612 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH HEINRICH Owner/President 337-609-1221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease |
| Additional Taxonomies | 208600000X Surgery |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2024-11-21 |
| Last Update Date | 2025-01-23 |