| NPI | 1538306337 |
|---|---|
| Former Name | LAUREN IMWALLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: KY 46348) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: IN 01072449A) |
| 2085R0001X Radiology Radiation Oncology (Licence: OH 35.121157) | |
| Enumeration Date | 2009-01-15 |
| Last Update Date | 2021-06-04 |