| NPI | 1770736613 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | KARYN RAE Director 843-876-1344 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) | 
| Additional Taxonomies | 208600000X Surgery | 
| Enumeration Date | 2008-10-23 | 
| Last Update Date | 2008-11-21 |