| NPI | 1891385621 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA AP61134921) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA AP61134921) |
| Enumeration Date | 2021-01-25 |
| Last Update Date | 2021-03-04 |