| NPI | 1487834073 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GODSON G KOTIA Owner 269-651-7003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MI 4301078341) |
| Enumeration Date | 2007-11-12 |
| Last Update Date | 2009-05-05 |