| NPI | 1760744155 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085N0700X Radiology Neuroradiology (Licence: NJ 25MA11180100) |
| Additional Taxonomies | 2085N0700X Radiology Neuroradiology (Licence: PA MD464019) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: PA MD464019) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT202101) | |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2021-08-26 |