| NPI | 1669791083 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY L GLEESON Member 269-441-0444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MI TG013146) |
| Enumeration Date | 2010-05-25 |
| Last Update Date | 2010-10-14 |