| NPI | 1780489617 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA HAMMOND Director 843-384-3512 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology |
| Enumeration Date | 2025-02-14 |
| Last Update Date | 2025-06-09 |