| NPI | 1417911819 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI BURNS Hr 570-622-5455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2024-11-19 |