| NPI | 1639178320 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD00032624) |
| Additional Taxonomies | 2085N0904X (Licence: WA MD00032624) |
| Enumeration Date | 2005-07-15 |
| Last Update Date | 2012-01-27 |