| NPI | 1598109597 | 
|---|---|
| Former Name | HALEY DIANA ROUTH | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX Q3348) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| Enumeration Date | 2013-04-20 | 
| Last Update Date | 2024-12-18 |