| NPI | 1639924319 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS N DZEBOLO Mdical Director 747-215-6350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology |
| Additional Taxonomies | 207UN0901X Nuclear Medicine Nuclear Cardiology |
| 2085R0204X Radiology Vascular & Interventional Radiology | |
| Enumeration Date | 2024-04-17 |
| Last Update Date | 2024-04-17 |