| NPI | 1356630800 |
|---|---|
| Former Name | JACQUELYN RAE GARCIA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: CO DR.0056367) |
| Additional Taxonomies | 2085P0229X Radiology Pediatric Radiology (Licence: CO DR.0056367) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: TX P9572) | |
| Enumeration Date | 2011-04-06 |
| Last Update Date | 2022-12-29 |