| 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 |