NPI | 1972610434 |
---|---|
Former Name | LESLIE KRISTINE WADE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A90322) |
Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: CA A90322) |
2085N0700X Radiology, Neuroradiology (Licence: CA A90322) | |
2085N0904X Radiology, Nuclear Radiology (Licence: CA A90322) | |
2085P0229X Radiology, Pediatric Radiology (Licence: CA A90322) | |
2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA A90322) | |
2085R0205X Radiology, Radiological Physics (Licence: CA A90322) | |
2085U0001X Radiology, Diagnostic Ultrasound (Licence: CA A90322) | |
Enumeration Date | 2006-08-23 |
Last Update Date | 2016-12-12 |