NPI | 1104288893 |
---|---|
Former Name | MARIA GLAVIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NE 35645) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2016-03-22 |
Last Update Date | 2023-08-03 |