| NPI | 1114161429 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: WA OP60514877) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: CT 051768) |
| Enumeration Date | 2009-04-30 |
| Last Update Date | 2020-12-18 |