| NPI | 1659485928 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: OR MD23020) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: WA MD00039375) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2007-07-08 |