| NPI | 1053545863 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD462073) | 
| Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: WI 54640) | 
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 54640) | |
| Enumeration Date | 2009-05-07 | 
| Last Update Date | 2017-09-05 |