| NPI | 1780830562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: RI MD13533) |
| Additional Taxonomies | 2085N0700X (Licence: RI md13533) |
| 2085N0700X (Licence: MA 239061) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 239061) | |
| Enumeration Date | 2008-08-13 |
| Last Update Date | 2019-03-12 |