| NPI | 1649776782 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA 61690980) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME169644) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2023-00814) | |
| Enumeration Date | 2018-04-05 |
| Last Update Date | 2025-08-10 |