| NPI | 1215070503 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL SCOTT JULEFF Owner 985-373-7118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: LA 9083R) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2012-10-17 |