NPI | 1114214822 |
---|---|
Former Name | ANN TERESE PACKARD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 55745) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 6491) |
Enumeration Date | 2011-07-01 |
Last Update Date | 2022-05-23 |