| NPI | 1386999753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 86207) |
| Additional Taxonomies | 208600000X Surgery (Licence: WV mt202861) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-07-20 |
| Last Update Date | 2020-11-09 |