| NPI | 1760685077 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 70220) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL TRN10831) |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2022-04-18 |