| NPI | 1114150612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NC 2018-02951) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: PA OT012183) |
| Enumeration Date | 2009-08-31 |
| Last Update Date | 2021-04-16 |