| NPI | 1699157289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX 46731) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2025-03649) |
| Enumeration Date | 2015-06-19 |
| Last Update Date | 2026-01-16 |