| NPI | 1295057503 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINCENT V LIZAMA Manager 1671-777-5259 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GU M001519) |
| Additional Taxonomies | 2085U0001X Radiology, Diagnostic Ultrasound (Licence: GU M001519) |
| Enumeration Date | 2010-03-01 |
| Last Update Date | 2011-09-15 |