| NPI | 1619906831 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX M4436) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX PHY TEMP) |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2020-12-14 |