| NPI | 1104189745 |
|---|---|
| Former Name | MEREDITH LYNN DISHAROON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2018-00848) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 03317) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 5101020115) | |
| Enumeration Date | 2012-06-19 |
| Last Update Date | 2026-01-13 |