| NPI | 1316433873 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAIRAV SHAH Owner 307-570-5867 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: WY 9196A) |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207RC0000X Internal Medicine, Cardiovascular Disease | |
| Enumeration Date | 2018-07-09 |
| Last Update Date | 2018-07-09 |