| NPI | 1497957252 |
|---|---|
| Former Name | MICHELLE HEATHER GOLD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD442368) |
| Additional Taxonomies | 2085N0700X (Licence: PA MD442368) |
| 2085N0700X (Licence: NJ 25MA09105700) | |
| 2085N0700X (Licence: DE C1-0010118) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MT187793) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA09105700) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: DE C1-0010118) | |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2012-09-11 |