| NPI | 1265684864 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD60766812) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 049901) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CT 049901) | |
| Enumeration Date | 2008-10-15 |
| Last Update Date | 2019-02-13 |