| NPI | 1639480726 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 48921)  | 
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2010013461)  | 
| Enumeration Date | 2010-06-23 | 
| Last Update Date | 2016-06-30 |