| NPI | 1366250680 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIYA BOYCE Regional Credentialing Specialist 704-897-2261 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology |
| Enumeration Date | 2024-12-19 |
| Last Update Date | 2024-12-19 |