| NPI | 1891725867 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL HENRY VANDERLICK Chief Executor 337-291-1162 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA 14489R) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2008-09-30 |