| NPI | 1770880635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL L GINGRAS Vice President 239-598-3131 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology |
| Enumeration Date | 2011-02-11 |
| Last Update Date | 2012-11-26 |