| NPI | 1790994564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.126593) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116018884) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0109542053) | |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2019-04-08 |