| NPI | 1124515119 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY LANE BROOKS President 707-252-4955 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: CA G51713) |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2020-03-31 |