| NPI | 1124100656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301044266) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 24606) |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: MI 4301044266) | |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2011-10-13 |