| 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 |