| NPI | 1679962070 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME145783) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 125066348) |
| 208600000X Surgery (Licence: IL 125066348) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-01-22 |
| Last Update Date | 2025-09-02 |