| NPI | 1700830528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY HUMPHRIES Manager 912-961-9753 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2020-08-22 |