| NPI | 1235111535 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS GALEN VINCENT President 262-827-3144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WI 29313 020) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: WI 29313 020) |
| Enumeration Date | 2005-11-14 |
| Last Update Date | 2008-11-20 |