| NPI | 1619061165 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: OR MD201700) |
| Additional Taxonomies | 2085B0100X Radiology Body Imaging (Licence: WA MD60027940) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: WA MD60027940) | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2021-04-16 |