| NPI | 1932783149 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES WILIIAM MOCK Manager 225-963-0567 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| Enumeration Date | 2021-05-12 |
| Last Update Date | 2021-11-16 |