| NPI | 1831171370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIO MATOS-CRUZ Owner 812-886-4383 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: IN 01045697) |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2020-08-22 |