| NPI | 1851785711 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JODY STUCKY Partner 786-508-2936 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology |
| Enumeration Date | 2015-03-27 |
| Last Update Date | 2015-04-08 |