NPI | 1871555177 |
---|---|
Entity Type | Organization |
Authorized Contact | PREDRAG M. GAGIC President 318-253-8655 |
Organization Subpart ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: LA 05101R) |
Additional Taxonomies | 208600000X Surgery (Licence: LA 05101R) |
Enumeration Date | 2006-04-04 |
Last Update Date | 2018-10-17 |