| NPI | 1881733558 |
|---|---|
| Former Name | AMY KRISTEN RIDDLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: FL ME98736) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: NC 135564) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2012-03-06 |