| NPI | 1518258094 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME136788) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 60160) |
| Enumeration Date | 2011-05-02 |
| Last Update Date | 2024-01-16 |