| NPI | 1801024674 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 278918) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 258835) |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2015-10-29 |