NPI | 1851783955 |
---|---|
Entity Type | Organization |
Authorized Contact | GREG J GAVIN Network Administrator 318-212-8780 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine |
Additional Taxonomies | 208000000X Pediatrics |
Enumeration Date | 2015-02-26 |
Last Update Date | 2015-04-08 |