| NPI | 1457687782 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK WADE NIELSEN Md 712-271-8346 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: IA 30608) |
| Enumeration Date | 2009-10-21 |
| Last Update Date | 2009-10-21 |