| NPI | 1083610539 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO R5C04) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 0418805) |
| 2085B0100X Radiology, Body Imaging (Licence: MO R5C04) | |
| Enumeration Date | 2005-06-21 |
| Last Update Date | 2012-11-02 |