| NPI | 1518128552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: UT 63518301205) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: ID M-11609) |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2012-08-30 |