Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | P-114 | LA |
NPI | 1114173101 |
---|---|
Provider Name | Luis Eduardo Infante |
First Address | New Orleans, LA 70119-2714 |
Second Address | New Orleans, LA 70119-2714 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2008 |
Last Update Date | 11/08/2008 |