| NPI | 1982646329 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREG J. GAVIN Network Administrator 318-212-8780 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2020-08-22 |