| 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) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.131600) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD60912739) | |
| Enumeration Date | 2011-04-01 | 
| Last Update Date | 2024-09-12 |