| NPI | 1790983351 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 330564-01) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 29915) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: SC LL29915) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 63924) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 29915) | |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2025-09-25 |