| NPI | 1770601882 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 75640) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301085301) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301085301) | |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2019-07-05 |