| NPI | 1407418452 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: MI 4301511141) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: MD D0101570) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 43-51045165) | |
| Enumeration Date | 2019-06-30 |
| Last Update Date | 2024-09-09 |