| NPI | 1962712521 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATT GRONINGER Executive Director 504-894-6771 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207QA0000X Family Medicine, Adolescent Medicine (Licence: LA 256) |
| Enumeration Date | 2010-10-18 |
| Last Update Date | 2018-05-10 |