| NPI | 1669036307 |
|---|---|
| Former Name | JEANNE MARIE KOCHKODAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301511184) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2019-04-29 |
| Last Update Date | 2024-07-22 |