| NPI | 1679787311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: WA MD60207514) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT188427) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2017-04-11 |