| NPI | 1992036651 |
|---|---|
| Former Name | SERENA LYNN MCCLAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D70319) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: DC 9557275) |
| Enumeration Date | 2010-01-20 |
| Last Update Date | 2012-05-08 |