| NPI | 1205515954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085U0001X Radiology, Diagnostic Ultrasound (Licence: GA 169738) |
| Additional Taxonomies | 293D00000X Physiological Laboratory (Licence: GA 169738) |
| Enumeration Date | 2023-07-11 |
| Last Update Date | 2024-01-11 |