| NPI | 1124559091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD61411090) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: ID 4581708) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301506427) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX S0129) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 81643) | |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2026-07-02 |