| NPI | 1073908778 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301503843) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 67214) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 56002) | |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2023-01-04 |