| NPI | 1679180020 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEAN NICHOLAS DEBARROS Member 225-278-3775 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2020-09-29 |
| Last Update Date | 2022-02-08 |