| NPI | 1063408086 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 74056) |
| Additional Taxonomies | 2085U0001X Radiology, Diagnostic Ultrasound (Licence: MA 74056) |
| Enumeration Date | 2005-09-26 |
| Last Update Date | 2012-08-08 |