| NPI | 1720066657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: AZ 41711) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: PA MD426580) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: NY 188881) | |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2019-01-22 |