| NPI | 1215407218 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABID C MOGANNAM Vascular Surgeon 408-899-8272 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X |
| Additional Taxonomies | 208600000X Surgery |
| Enumeration Date | 2018-12-03 |
| Last Update Date | 2018-12-04 |