| NPI | 1114561305 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER SHAWN SKILLERN Owner / President 805-444-4491 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery |
| Enumeration Date | 2019-10-31 |
| Last Update Date | 2020-02-11 |