| NPI | 1255355715 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBY I SHYTLES Credentialing 940-387-7588 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery |
| Additional Taxonomies | 208600000X Surgery |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2009-11-05 |