| NPI | 1043200728 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY TP961) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX L7171) |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2021-03-29 |