| NPI | 1518301787 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 297689) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 68183) |
| 363AM0700X Physician Assistant, Medical (Licence: NY 297689) | |
| Enumeration Date | 2013-04-18 |
| Last Update Date | 2023-07-17 |