| NPI | 1568407757 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN PERRY AO 267-249-1745 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology |
| 2085R0204X Radiology, Vascular & Interventional Radiology | |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2024-03-06 |