| NPI | 1932302650 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONY KINKADE Business Manager 505-522-5955 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: NM 2001-231) |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2007-09-24 |