| NPI | 1588696058 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: DE C1-0003051) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35-067475) |
| 208D00000X General Practice (Licence: MD D0065586) | |
| 208D00000X General Practice (Licence: OH 35.067475) | |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2021-05-13 |