| NPI | 1760545867 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLUSEGUN ADEDAMOLA ADELEYE President 318-356-7211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: LA 200937) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2011-11-23 |