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 |