| NPI | 1912435710 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK DAWSON Owner 337-334-7551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2017-05-24 |
| Last Update Date | 2022-07-21 |