| NPI | 1417140914 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X (Licence: VA 0109542066) |
| Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: PA MT190707) |
| Enumeration Date | 2007-08-20 |
| Last Update Date | 2009-07-23 |