| NPI | 1619222833 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301500997) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 66271) |
| Enumeration Date | 2012-07-14 |
| Last Update Date | 2023-02-06 |