| NPI | 1023329513 |
|---|---|
| Former Name | HEATHER M IMSANDE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MT Med-PHY-LIC-57569) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: RI 15374) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 262636) | |
| Enumeration Date | 2010-06-29 |
| Last Update Date | 2020-07-30 |