| NPI | 1215908686 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: SD 7569) |
| Additional Taxonomies | 2085R0001X (Licence: MN 47876) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: SD 7569) | |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2022-07-06 |