| NPI | 1902003775 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK W SHELTON Chief Manager 816-832-8186 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: TN 24579) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2020-08-22 |