| NPI | 1083020820 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD61036239) | 
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A159414) | 
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX T7407) | |
| Enumeration Date | 2014-07-01 | 
| Last Update Date | 2025-01-31 |