| NPI | 1104051143 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME110739) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 80767) |
| Enumeration Date | 2009-05-20 |
| Last Update Date | 2019-11-06 |