| NPI | 1184618225 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEHDI A MARVASTI Owner 315-422-4422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| Enumeration Date | 2005-09-06 |
| Last Update Date | 2020-08-22 |