| NPI | 1972259547 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONI COOPER Director Of Credentialing 754-206-6198 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology |
| Enumeration Date | 2022-02-23 |
| Last Update Date | 2023-03-21 |