| NPI | 1548451727 |
|---|---|
| Former Name | MARY KRISTEN JESSE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 51283) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX BP10029237) |
| 2085N0904X Radiology, Nuclear Radiology (Licence: CO 51283) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CO 51283) | |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2024-07-23 |