| NPI | 1467862078 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEVERLY ANN OUTRAM Surgical Assistant 225-803-1794 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| Enumeration Date | 2014-05-05 |
| Last Update Date | 2014-05-05 |