| NPI | 1659502771 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PR 19019) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 19019) |
| Enumeration Date | 2009-08-06 |
| Last Update Date | 2015-06-17 |