| NPI | 1558758516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: PA MD463507) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: FL ME165122) |
| Enumeration Date | 2015-04-16 |
| Last Update Date | 2024-05-06 |