NPI | 1225267230 |
---|---|
Former Name | MARY MARGARET MITCHELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 27690) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 9407205) |
Enumeration Date | 2009-07-11 |
Last Update Date | 2015-06-02 |