| NPI | 1104117209 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology Pediatric Radiology (Licence: MA 262004) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: PA MD460951) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: MA 262004) | |
| Enumeration Date | 2011-04-22 |
| Last Update Date | 2022-10-26 |