| NPI | 1063614774 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 35046) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 17091) |
| 208D00000X General Practice (Licence: PR 17091) | |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2021-08-24 |