| NPI | 1982677571 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 179550) |
| Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: TN 60248) |
| 2085P0229X Radiology, Pediatric Radiology (Licence: GA 043279) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 60248) | |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2024-06-24 |