| NPI | 1942230578 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ATHEL BERT SPARROW President 502-361-6075 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: KY 13980) |
| Additional Taxonomies | 208600000X Surgery (Licence: KY 13980) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2008-04-24 |