| NPI | 1962533604 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL ANTHONY BALLARD Owner 225-294-7872 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: LA MD.09071R) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2020-08-22 |