| NPI | 1790104701 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD462331) |
| Additional Taxonomies | 2085N0904X (Licence: NJ 25MA10912200) |
| 2085N0904X (Licence: PA MD462331) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA10912200) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 278093) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-08 |
| Last Update Date | 2023-04-12 |