| NPI | 1174575005 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH HOLDREN CAO 570-271-5490 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2008-06-30 |