| NPI | 1508127283 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: MO 2021041781) |
| Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: NC 2019-01502) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 82509) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD460805) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NC 2019-01502) | |
| Enumeration Date | 2012-05-30 |
| Last Update Date | 2021-12-27 |