| NPI | 1649896820 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY GANDY Owner 414-687-0307 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| Enumeration Date | 2020-06-23 |
| Last Update Date | 2020-06-23 |