| NPI | 1457629941 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANUKWARE K KETOSUGBO Owner 718-622-1301 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NY 147545) |
| Additional Taxonomies | 2086S0129X (Licence: NY 147545) |
| Enumeration Date | 2011-12-12 |
| Last Update Date | 2015-07-15 |