| NPI | 1568803591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NM MD2019-0661) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125063853) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125063853) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: LA 303435) | |
| Enumeration Date | 2013-07-05 |
| Last Update Date | 2019-08-15 |