| NPI | 1548699606 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKY BROWNING Office Manager 386-672-9501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: FL 58979) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: FL 58979) |
| Enumeration Date | 2013-11-08 |
| Last Update Date | 2013-11-13 |