| NPI | 1710763925 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA ROCHELLE WEITZ Owner 225-773-0473 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine | |
| 207R00000X Internal Medicine | |
| 208800000X Urology | |
| Enumeration Date | 2023-09-04 |
| Last Update Date | 2023-10-29 |