| NPI | 1508829599 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH ANN CLUBB President/ Surgeon 225-766-7771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: LA 11291R) |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2008-05-13 |