| NPI | 1568690469 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN J BOUDREAUX Manager 225-588-4644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: LA MD.201940) |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2021-04-01 |