| NPI | 1710237953 |
|---|---|
| Former Name | JENIFER E. ERICKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 247100000X Radiologic Technologist (Licence: IL 500502125) |
| Additional Taxonomies | 247200000X |
| Enumeration Date | 2012-09-14 |
| Last Update Date | 2012-09-18 |