| NPI | 1114245388 |
|---|---|
| Former Name | MARILOU B BASTAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: PA MD440189) |
| Enumeration Date | 2010-05-12 |
| Last Update Date | 2020-03-03 |