NPI | 1982725347 |
---|---|
Former Name | JEANNETTE A. GLOTZBACH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-20887) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO R1F44) |
208D00000X General Practice (Licence: KS 0420887) | |
208D00000X General Practice (Licence: MO R1F44) | |
Enumeration Date | 2007-04-03 |
Last Update Date | 2007-07-09 |