| NPI | 1568419224 |
|---|---|
| Professional Name | N/A N/A N/A |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME148037) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX 44400) |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2024-01-02 |