| NPI | 1063531119 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2011-00963) |
| Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: NC 2011-00963) |
| 2085P0229X Radiology, Pediatric Radiology (Licence: SC 35098) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 35098) | |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2017-12-20 |