| NPI | 1770699605 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X (Licence: PA MD009376E) |
| Additional Taxonomies | 2085R0203X Radiology, Therapeutic Radiology (Licence: PA md009376E) |
| 2085R0001X (Licence: NJ 25MA08110400) | |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2022-07-12 |