| NPI | 1669659009 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NASSER RAZACK Owner 864-850-1441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: FL ME92656) |
| Additional Taxonomies | 2085D0003X Radiology Diagnostic Neuroimaging (Licence: FL ME92656) |
| 2085N0700X Radiology Neuroradiology (Licence: FL ME92656) | |
| Enumeration Date | 2008-01-29 |
| Last Update Date | 2018-06-21 |