| 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 (Licence: CA A90322) | |
| 2085N0904X (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 |