| NPI | 1831597137 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUDOLPH CASANOVA CLARKE Owner 504-621-2306 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: LA 305R00000X) |
| Enumeration Date | 2014-12-18 |
| Last Update Date | 2014-12-18 |