| NPI | 1578904686 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: MS 25962) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: MS T-2734) |
| Enumeration Date | 2013-07-17 |
| Last Update Date | 2018-08-01 |