| NPI | 1104610708 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 82927) |
| Additional Taxonomies | 208600000X Surgery (Licence: MN 35296) |
| Enumeration Date | 2025-04-08 |
| Last Update Date | 2026-07-28 |