| NPI | 1831330851 | 
|---|---|
| Former Name | LASHONDA DENISE WATTS | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 59576)  | 
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: ND 13696)  | 
| Enumeration Date | 2009-03-20 | 
| Last Update Date | 2021-07-22 |