| NPI | 1801008396 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER FONSECA President 314-543-5252 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MO 116658) |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2010-01-04 |