| NPI | 1154422384 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171000000X Military Health Care Provider (Licence: CO 42795) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 42795) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2022-03-03 |