NPI | 1063771889 |
---|---|
Former Name | JILL SARA PANOSIAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD187189) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A147451) |
Enumeration Date | 2012-05-14 |
Last Update Date | 2018-08-01 |