| NPI | 1164745238 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATHEW NINAN Owner 901-259-4130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TN MD5950415) |
| Enumeration Date | 2010-03-03 |
| Last Update Date | 2010-03-03 |