| NPI | 1164778049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES ALBERT BROCKENBROUGH Owner 816-813-8308 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: KS 0432320) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MO 2009015153) |
| Enumeration Date | 2012-07-30 |
| Last Update Date | 2024-03-05 |