| NPI | 1356669279 |
|---|---|
| Former Name | ANNEMARIE THERESE FERNANDES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: WA MD61586810) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: NJ 25MA09669900) |
| Enumeration Date | 2010-05-17 |
| Last Update Date | 2024-08-22 |