| NPI | 1790077113 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: KY 50208) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: TN 53919) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: MS 26026) | |
| Enumeration Date | 2011-05-03 |
| Last Update Date | 2023-10-31 |