NPI | 1962891739 |
---|---|
Former Name | KATHERINE BRUKSCH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036157410) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 125.066337) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: IL B62050589644) | |
Enumeration Date | 2015-01-16 |
Last Update Date | 2021-09-23 |