| NPI | 1013960160 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTOR H GUNDERSON Client Support Rep/Credentialing 337-289-2180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2008-03-28 |