| NPI | 1790739134 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL LANE Practice Manager 843-556-0036 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: SC 14892) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2007-09-10 |