| NPI | 1518311844 |
|---|---|
| Former Name | AUDREY ROSE NELSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 65520) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 217958) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 217958) | |
| Enumeration Date | 2016-04-23 |
| Last Update Date | 2022-08-24 |