| NPI | 1699030759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X (Licence: KY 60484) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 56955) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 60484) | |
| Enumeration Date | 2012-07-05 |
| Last Update Date | 2025-07-01 |