| NPI | 1447654066 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENXING FAN Manager 860-801-0330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0200X Clinic/Center, Radiology (Licence: MA 129878) |
| Additional Taxonomies | 261QR0208X Clinic/Center, Radiology, Mobile (Licence: MA 129878) |
| Enumeration Date | 2014-10-09 |
| Last Update Date | 2014-12-08 |