NPI | 1982087987 |
---|---|
Entity Type | Organization |
Authorized Contact | LISA KATHERINE TABOR Owner 337-804-2049 |
Organization Subpart ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: LA AP04615) |
Enumeration Date | 2015-07-08 |
Last Update Date | 2015-07-08 |