| NPI | 1184828972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA C175118) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101244209) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME179165) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: ID 4771058) | |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2026-02-05 |