| NPI | 1629084447 |
|---|---|
| Former Name | AMY RACHELLE LANTIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A99993) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX L7352) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2020-12-17 |