| NPI | 1770825614 |
|---|---|
| Former Name | ANIKA L MIRICK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 304517-01) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD60577013) |
| Enumeration Date | 2013-03-18 |
| Last Update Date | 2023-08-28 |