| NPI | 1689812356 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX Q7587) | 
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A111436) | 
| 207R00000X Internal Medicine (Licence: OH 57014972) | |
| Enumeration Date | 2009-02-03 | 
| Last Update Date | 2021-12-01 |