| NPI | 1114214202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: RI 15254) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 277219) |
| 208D00000X General Practice (Licence: MI 1742220) | |
| Enumeration Date | 2011-07-08 |
| Last Update Date | 2019-03-12 |