Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174V00000X | Clinical Ethicist | LA |
NPI | 1962804542 |
---|---|
Provider Name | Mr. Eric Schultheis |
First Address | Marrero, LA 70072-1925 |
Second Address | Marrero, LA 70072-1925 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2014 |
Last Update Date | 25/09/2014 |