| NPI | 1255695763 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 269620) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 252370) | 
| Enumeration Date | 2012-06-28 | 
| Last Update Date | 2017-02-23 |