| NPI | 1588690960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X (Licence: NY 276494) |
| Additional Taxonomies | 2085N0904X (Licence: PA MD066340L) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD066340L) | |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2021-03-12 |