| NPI | 1679351985 |
|---|---|
| Former Name | DIANE MARIE DAMON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085U0001X Radiology Diagnostic Ultrasound (Licence: AZ 93306) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: MI 177185) |
| Enumeration Date | 2023-09-18 |
| Last Update Date | 2023-09-18 |