| NPI | 1780973503 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: CA A153061) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: KY 50955) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: CT 67438) | |
| Enumeration Date | 2011-04-01 |
| Last Update Date | 2021-03-09 |