| NPI | 1710208210 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 262514) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116022669) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD60393377) | |
| Enumeration Date | 2010-06-18 |
| Last Update Date | 2015-07-10 |