| NPI | 1073793063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HADI ASSAD SHALHOUB Owner 772-581-8900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: FL OS 7619) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL OS 7619) |
| Enumeration Date | 2007-11-07 |
| Last Update Date | 2008-10-08 |