| NPI | 1124553839 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY BORDERS Owner 808-341-7567 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: IN 01058854A) |
| Enumeration Date | 2017-05-01 |
| Last Update Date | 2017-05-05 |