| NPI | 1053510073 | 
|---|---|
| Former Name | KIM O LE | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX M7361) | 
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD434150) | 
| Enumeration Date | 2007-07-11 | 
| Last Update Date | 2019-02-07 |