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 |