| NPI | 1275520512 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301074481) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MI 4301074481) |
| Enumeration Date | 2005-10-03 |
| Last Update Date | 2020-10-07 |