| NPI | 1528193505 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT L RUDOLPH Owner 304-424-2102 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WV 12909) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: WV 12909) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: WV 12909) | |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2008-08-19 |