| NPI | 1265551006 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: MI 4301089420) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: WI 55686) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301089420) | |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2022-05-11 |