| NPI | 1821096645 |
|---|---|
| Former Name | PATRICIA POTTER BRANTLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 039937) |
| Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: GA 039937) |
| Enumeration Date | 2005-07-14 |
| Last Update Date | 2007-10-08 |