363LA2100X
Shreveport, LA
Specialty
363LA2100X
Credential
ACNP-BC
NPI
1093825382
3217 Mabel St, Shreveport, LA 71103
(318) 631-9121Confirm current license and practice information on the official CMS NPI registry.
View NPI RecordThis surgeon specializes in 363la2100x procedures performed in an outpatient ambulatory surgical setting.
NUCC Taxonomy: 363LA2100X