| NPI | 1396002796 |
|---|---|
| Former Name | GRACE CHRISTIAN INGRAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301512893) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 57364) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MS 25685) | |
| Enumeration Date | 2012-04-23 |
| Last Update Date | 2025-01-02 |