NPI | 1972732501 |
---|---|
Former Name | JESSICA SUSZANSKI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: TN 67046) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301095170) |
2085R0202X Radiology, Diagnostic Radiology (Licence: TN 67046) | |
Enumeration Date | 2009-07-02 |
Last Update Date | 2024-11-20 |