| NPI | 1528126109 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: PA MT205687) |
| Additional Taxonomies | 111NR0200X Chiropractor Radiology (Licence: MN 003430) |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2016-07-10 |