| NPI | 1609430776 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 76800) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 65075) |
| Enumeration Date | 2019-04-24 |
| Last Update Date | 2024-05-14 |