| NPI | 1306424635 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: NY 322167) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NY 322167) |
| Enumeration Date | 2021-03-30 |
| Last Update Date | 2023-04-03 |