| NPI | 1114250990 |
|---|---|
| Former Name | LISA EDENBAUM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME131089) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME131089) |
| Enumeration Date | 2009-09-11 |
| Last Update Date | 2024-12-27 |