| NPI | 1477970564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A142301) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX BP10049186) |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2020-05-05 |