| NPI | 1518597285 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OR 910569) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2020-01-22 |
| Last Update Date | 2020-01-22 |