| NPI | 1881901189 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLIN E BAILEY Owner 573-302-0032 |
| Organization Subpart ? | No |
| Primary Taxonomy | 202K00000X (Licence: HI 15676) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: HI 15676) |
| Enumeration Date | 2010-09-08 |
| Last Update Date | 2010-09-08 |