| NPI | 1043579204 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD60935288) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 266162) |
| Enumeration Date | 2012-05-09 |
| Last Update Date | 2019-07-19 |