| NPI | 1386031649 |
|---|---|
| Former Name | KATY ELIZABETH BALAZY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: OR 203975) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: WA MD.MD.61148904) |
| Enumeration Date | 2015-04-23 |
| Last Update Date | 2021-07-16 |