NPI | 1922447895 |
---|---|
Former Name | CRYSTAL RENE NORGREN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: CA A156125) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301102929) |
Enumeration Date | 2013-06-24 |
Last Update Date | 2019-06-25 |