| NPI | 1750811014 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085P0229X Radiology Pediatric Radiology (Licence: OH 39.149975) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MO 2017020341) |
| 2085P0229X Radiology Pediatric Radiology (Licence: KY TP647) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: IL 125075398) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-06-19 |
| Last Update Date | 2025-08-25 |