| NPI | 1548701865 |
|---|---|
| Former Name | ALLISON MARIE BLAKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: IL 125.070823) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: IL 036170807) |
| Enumeration Date | 2017-03-20 |
| Last Update Date | 2024-07-11 |