| NPI | 1104146604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: TX 45509) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX BP10034437) |
| Enumeration Date | 2010-06-07 |
| Last Update Date | 2020-08-10 |