| NPI | 1104270537 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: WA MD61586073) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD61586073) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: WA MD61586073) | |
| Enumeration Date | 2016-04-22 |
| Last Update Date | 2024-09-06 |