| NPI | 1063582484 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENICE TARRANT Office Manager 757-491-6467 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: VA 0101 044559) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101 044559) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2012-12-19 |