| NPI | 1700074077 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID A DEPP Owner 225-769-9631 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: LA 010566) |
| Enumeration Date | 2007-10-11 |
| Last Update Date | 2007-10-11 |