NPI | 1679992606 |
---|---|
Former Name | ALLISON OLIVIA BACKER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 65237) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NH 1679992606) |
2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0068262) | |
Enumeration Date | 2014-04-07 |
Last Update Date | 2024-11-12 |