| NPI | 1699735019 | 
|---|---|
| Former Name | NAKIISA M JOHNSON | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01058163A) | 
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.085961) | 
| Enumeration Date | 2006-03-28 | 
| Last Update Date | 2021-01-13 |