| NPI | 1598290249 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREG J GAVIN Network Administrator 318-212-8780 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2088F0040X Urology, Female Pelvic Medicine and Reconstructive Surgery |
| Enumeration Date | 2017-05-01 |
| Last Update Date | 2017-05-01 |