| NPI | 1104866599 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCY F DERMO Business Manager 478-743-9762 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| 2086S0129X | |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2025-09-11 |