| NPI | 1871236604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX w4187) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: LA 350737) |
| Enumeration Date | 2022-04-19 |
| Last Update Date | 2026-06-28 |