| NPI | 1477398956 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA B WILSON Nurse Practitioner 337-534-0420 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center Primary Care |
| 261QX0100X Clinic/Center Occupational Medicine | |
| Enumeration Date | 2024-06-27 |
| Last Update Date | 2024-10-31 |