| NPI | 1558721803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 291823) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 88045) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-02-29 |
| Last Update Date | 2022-07-11 |