| NPI | 1942545975 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EROMOSELE ANTHONY OTOADESE Owner 319-233-3044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: IA 28663) |
| Enumeration Date | 2012-12-03 |
| Last Update Date | 2020-04-29 |