| NPI | 1629240627 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2085R0001X  (Licence: KY 53325)  | 
| Additional Taxonomies | 2085R0001X  (Licence: KY TP732)  | 
| 2085R0203X Radiology, Therapeutic Radiology (Licence: MD D0066632)  | |
| 2085R0203X Radiology, Therapeutic Radiology (Licence: KY TP732)  | |
| Enumeration Date | 2008-03-31 | 
| Last Update Date | 2021-08-10 |