| NPI | 1558386607 |
|---|---|
| Former Name | TERRI LYNN BOTT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MI 4301077359) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MI 077359) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2011-11-19 |