| NPI | 1104312628 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN K OLSON Owner / President 239-318-9284 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine Hematology & Oncology |
| Additional Taxonomies | 207RX0202X Internal Medicine Medical Oncology |
| 207RH0000X Internal Medicine Hematology | |
| 2085R0202X Radiology Diagnostic Radiology | |
| 208800000X Urology | |
| Enumeration Date | 2018-07-09 |
| Last Update Date | 2024-08-28 |