| NPI | 1902337637 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FADY WANNA M.D. 478-955-1804 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: GA 043813) |
| Enumeration Date | 2017-03-24 |
| Last Update Date | 2017-03-24 |