| NPI | 1952378283 |
|---|---|
| Former Name | AYODALE SAMUELLA JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A104364) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MA 225130) |
| Enumeration Date | 2006-03-06 |
| Last Update Date | 2022-01-28 |