| NPI | 1053511873 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAPAN ROY Medical Director 314-504-2009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0203X Radiology, Therapeutic Radiology |
| Additional Taxonomies | 2085R0001X (Licence: MO R4B37) |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2021-08-23 |