| NPI | 1427743210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOURDAN STRISHOCK Enrollment 814-375-6160 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| Enumeration Date | 2023-04-07 |
| Last Update Date | 2023-04-07 |