| NPI | 1104236371 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: OR PA175874) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA175874) |
| Enumeration Date | 2014-04-28 |
| Last Update Date | 2026-01-07 |