NPI | 1205399227 |
---|---|
Former Name | BRITTANY ASHLYN FOWLER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME151276) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2019-04-08 |
Last Update Date | 2024-04-27 |