NPI | 1841419454 |
---|---|
Entity Type | Organization |
Authorized Contact | JOHN WILLIS PUCKETT Vascular Surgeon 949-574-7176 |
Organization Subpart ? | No |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: CA G38172A) |
Enumeration Date | 2007-04-24 |
Last Update Date | 2014-02-03 |