| NPI | 1255593745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME126697) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: RI 15071) |
| 208600000X Surgery (Licence: RI LP01364) | |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2021-06-11 |