| NPI | 1225474612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: MO 2020035065) |
| Additional Taxonomies | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: IL 036.141212) |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: MO 2020035065) | |
| Enumeration Date | 2013-05-13 |
| Last Update Date | 2021-08-04 |