| NPI | 1770399776 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISHA FALK Vice President 337-609-1221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2024-12-05 |
| Last Update Date | 2024-12-05 |