| NPI | 1275152522 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNA HALL Credentialing Specialist 702-719-8952 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| Enumeration Date | 2020-04-15 |
| Last Update Date | 2020-04-15 |