| NPI | 1548823289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: GA 98799) |
| Additional Taxonomies | 261QR0206X Clinic/Center Radiology, Mammography (Licence: GA 98799) |
| 261QR0207X Clinic/Center Radiology, Mobile Mammography (Licence: GA 98799) | |
| Enumeration Date | 2019-04-18 |
| Last Update Date | 2024-03-13 |