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 |