NPI | 1083857817 |
---|---|
Former Name | KRISTINE EMALINE TATE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A106633) |
Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: WA MD60592175) |
2085P0229X Radiology, Pediatric Radiology (Licence: CA A106633) | |
2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD60592175) | |
Enumeration Date | 2009-04-09 |
Last Update Date | 2019-08-23 |