| NPI | 1790973451 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 43029) |
| Additional Taxonomies | 2085N0700X (Licence: KY 43029) |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2012-12-04 |