| NPI | 1487958773 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OSAGIE OWEN ODEH President 504-258-4474 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: TX 801352082) |
| Enumeration Date | 2011-01-01 |
| Last Update Date | 2011-01-01 |