| NPI | 1639507585 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW T WALKER Officer 772-323-7321 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: FL EXEMPT) |
| Additional Taxonomies | 2085N0700X Radiology Neuroradiology (Licence: FL EXEMPT) |
| Enumeration Date | 2013-10-30 |
| Last Update Date | 2013-10-30 |