| NPI | 1104459783 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAD SHALHOUB External Consultant 772-230-4477 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2020-02-21 |
| Last Update Date | 2023-01-19 |