| NPI | 1497718266 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM R WILSON Owner 870-862-4551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: AR D99757) |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2020-08-22 |