| NPI | 1134407075 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM RONNING Attorney 912-355-8188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: GA 64818) |
| Enumeration Date | 2011-07-26 |
| Last Update Date | 2011-07-26 |