| NPI | 1003264011 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA 20A18632) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA OT017122) |
| Enumeration Date | 2016-05-31 |
| Last Update Date | 2021-08-25 |