| NPI | 1497755565 |
|---|---|
| Former Name | ELLEN C ANDERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036.078263) |
| Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: IL 036078263) |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2019-11-15 |