| NPI | 1144475401 |
|---|---|
| Former Name | GENEVA JEANNE RANDALL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD447249) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 267509) |
| Enumeration Date | 2008-11-28 |
| Last Update Date | 2021-03-29 |