| NPI | 1639604739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: AZ 57021) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ R76278) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: AZ R76278) | |
| Enumeration Date | 2017-04-26 |
| Last Update Date | 2024-03-21 |