| NPI | 1659124485 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM LEGENDRE BOUDREAUX Director Of Contracting 985-493-4907 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology |
| Enumeration Date | 2024-04-10 |
| Last Update Date | 2025-06-02 |