| NPI | 1043206568 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: MA 59103) |
| Additional Taxonomies | 2085N0700X Radiology Neuroradiology (Licence: MA 59103) |
| 2085P0229X Radiology Pediatric Radiology (Licence: MA 59103) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: MA 59103) | |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: MA 59103) | |
| 2085U0001X Radiology Diagnostic Ultrasound (Licence: MA 59103) | |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2020-04-17 |