| NPI | 1972732501 |
|---|---|
| Former Name | JESSICA SUSZANSKI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301095170) |
| Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: TN 67046) |
| Enumeration Date | 2009-07-02 |
| Last Update Date | 2023-06-20 |