| NPI | 1215131404 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD61029857) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX M0346) |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2020-08-07 |