| NPI | 1386823045 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL J MITCHELL Owner President 716-282-0349 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: NY 1918411) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 1918411) |
| Enumeration Date | 2007-10-30 |
| Last Update Date | 2007-10-30 |