| NPI | 1790017291 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM H MONTANO Officer 907-452-8151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: AK MD1335) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: AK MD1335) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: AK MD1335) | |
| Enumeration Date | 2010-02-08 |
| Last Update Date | 2010-12-17 |