| NPI | 1619214434 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREG J GAVIN Network Administrator 318-212-2870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology |
| Enumeration Date | 2013-01-14 |
| Last Update Date | 2013-01-14 |