| NPI | 1124051735 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATEO V. GUANZON President 219-836-2022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: IN 01035781A) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: IN 01035781A) |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2011-03-22 |