NPI | 1699821298 |
---|---|
Former Name | MISTY DAWN MANUEL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: LA 025987) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 239109) |
Enumeration Date | 2007-01-26 |
Last Update Date | 2015-03-10 |