| NPI | 1164762316 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN VAUGHN AO 629-317-1465 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 363A00000X Physician Assistant | |
| 2085R0204X Radiology, Vascular & Interventional Radiology | |
| Enumeration Date | 2013-02-26 |
| Last Update Date | 2026-03-25 |