NPI | 1811948037 |
---|---|
Entity Type | Organization |
Authorized Contact | MIKE BREARD Vice President 318-361-0900 |
Organization Subpart ? | No |
Primary Taxonomy | 2080A0000X Pediatrics Adolescent Medicine |
Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics |
Enumeration Date | 2006-05-12 |
Last Update Date | 2011-07-05 |