| NPI | 1093036659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SERRIE C. LICO President 716-821-7714 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NY 184556-1) |
| Enumeration Date | 2010-06-17 |
| Last Update Date | 2013-01-22 |