| NPI | 1700894557 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: MO 105797) |
| Additional Taxonomies | 2085B0100X Radiology Body Imaging (Licence: MO 105797) |
| 2085U0001X Radiology Diagnostic Ultrasound (Licence: MO 105797) | |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2021-03-31 |