NPI | 1912936196 |
---|---|
Entity Type | Organization |
Authorized Contact | GREG J. GAVIN Network Administrator 318-212-3223 |
Organization Subpart ? | No |
Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
Enumeration Date | 2006-07-01 |
Last Update Date | 2012-06-08 |