| NPI | 1205030574 |
|---|---|
| Former Name | HOLLY REID NELSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35-093511) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 57007596) |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2009-12-14 |