| NPI | 1972037455 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISHA FALK VP Of Contracting 337-609-1221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363LA2100X Nurse Practitioner, Acute Care | |
| Enumeration Date | 2017-04-12 |
| Last Update Date | 2022-03-23 |