| NPI | 1790077162 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOROTHY H BANISH Owner 985-893-4711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: LA 015918) |
| Enumeration Date | 2011-05-04 |
| Last Update Date | 2011-05-04 |