| NPI | 1376749655 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD60289762) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 103867) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 51066) | |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2012-07-11 |