| NPI | 1811667165 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085U0001X Radiology Diagnostic Ultrasound (Licence: MS 244064) |
| Additional Taxonomies | 246RM2200X Technician, Pathology Medical Laboratory (Licence: MS 100410) |
| Enumeration Date | 2021-09-17 |
| Last Update Date | 2021-09-17 |