| NPI | 1548351323 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD073719L) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: PA MD073719L) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2008-08-01 |