| NPI | 1578894853 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX P0237) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD60139989) |
| 282N00000X General Acute Care Hospital (Licence: PA MT-187804) | |
| Enumeration Date | 2010-01-26 |
| Last Update Date | 2020-09-17 |