| NPI | 1093812299 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY P LANGE Practice Administrator 804-272-4761 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2020-08-22 |