| NPI | 1609034396 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAE CREWS Director Of Operation 662-579-3484 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery |
| Enumeration Date | 2008-05-29 |
| Last Update Date | 2024-06-12 |