| NPI | 1558386045 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: OR MD25785) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: WA MD00044579) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: CA A90476) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: LA L#026146) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2007-10-19 |