| NPI | 1710242516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: AZ 65767) |
| Additional Taxonomies | 2085B0100X Radiology Body Imaging (Licence: MO 2017011899) |
| Enumeration Date | 2012-07-08 |
| Last Update Date | 2022-07-08 |