| NPI | 1114077062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: MO 2012040468) |
| Additional Taxonomies | 174400000X Specialist (Licence: MI 5101012671) |
| 2085P0229X Radiology, Pediatric Radiology (Licence: KS 0536143) | |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2013-01-04 |