| NPI | 1023831047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTY MUSIC Director Provider Enrollment 877-952-3815 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2024-11-07 |
| Last Update Date | 2024-11-07 |