| NPI | 1669761722 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 54291) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX 9584BP1-0037436) |
| Enumeration Date | 2011-03-29 |
| Last Update Date | 2015-06-30 |