| NPI | 1770806077 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY WAGGENSPACK Owner 504-875-4029 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA MD203258) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: LA MD203258) |
| Enumeration Date | 2010-03-01 |
| Last Update Date | 2011-03-11 |