| NPI | 1104804343 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: MN 47298) |
| Additional Taxonomies | 2085P0229X Radiology Pediatric Radiology (Licence: PA MD476651) |
| 2085P0229X Radiology Pediatric Radiology (Licence: WI 1886) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: PA MD476651) | |
| Enumeration Date | 2006-01-06 |
| Last Update Date | 2023-06-22 |