| NPI | 1114417797 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: TN 67948) |
| Additional Taxonomies | 261QR0200X Clinic/Center Radiology |
| Enumeration Date | 2018-05-18 |
| Last Update Date | 2023-07-04 |