| NPI | 1790705002 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOI DAI VO President 337-239-2606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2020-08-22 |