| NPI | 1902149339 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: WA MD61367722) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: LA 336448) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0116025756) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA 205466) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: WA MD61067485) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 71150) | |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2025-12-08 |