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 |