| NPI | 1912058538 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL HARTMAN Administrator 601-948-1416 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2020-08-22 |