| NPI | 1992149165 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QR0206X Clinic/Center, Radiology, Mammography (Licence: IL 036145354) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 29907) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-04-18 |
| Last Update Date | 2019-09-12 |