| NPI | 1023498805 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONI COOPER Director Of Credentialing 754-206-6198 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology |
| Enumeration Date | 2015-06-05 |
| Last Update Date | 2023-03-21 |