| NPI | 1215192067 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 247100000X Radiologic Technologist (Licence: TX 11952) | 
| Additional Taxonomies | 2471C3402X Radiologic Technologist, Radiography (Licence: TX 11952) | 
| Enumeration Date | 2008-07-22 | 
| Last Update Date | 2008-07-22 |