NPI | 1730642802 |
---|---|
Former Name | DANIELLE ANN BLY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301511363) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2019-04-07 |
Last Update Date | 2024-07-22 |