| NPI | 1336853019 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL LAVOR Owner 520-440-3004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 163WW0000X Registered Nurse, Wound Care |
| 363L00000X Nurse Practitioner | |
| 2086S0129X Surgery, Vascular Surgery | |
| Enumeration Date | 2023-01-09 |
| Last Update Date | 2023-10-03 |