| NPI | 1699732339 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: TN 36780) |
| Additional Taxonomies | 208D00000X General Practice (Licence: TN 36780A) |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2017-06-27 |