| NPI | 1962709048 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN MARIE HANCOCK President 910-612-5118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: VA 0101242791) |
| Enumeration Date | 2011-02-25 |
| Last Update Date | 2021-04-06 |