| NPI | 1053659524 |
|---|---|
| Former Name | DEIRDRE MICHELLE LACY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 247100000X Radiologic Technologist (Licence: MN 256240) |
| Additional Taxonomies | 247100000X Radiologic Technologist (Licence: OH R8866066) |
| 247100000X Radiologic Technologist (Licence: TX 97527) | |
| 247100000X Radiologic Technologist (Licence: CA RHM00096687) | |
| 247100000X Radiologic Technologist (Licence: RI RAD02210) | |
| 247100000X Radiologic Technologist (Licence: MS MRT5368) | |
| Enumeration Date | 2013-01-17 |
| Last Update Date | 2013-01-17 |