| NPI | 1639376502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN MD48259) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: SC LL29781) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 148792) | |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2012-08-06 |