| NPI | 1760798565 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 062413) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 103328) |
| 208600000X Surgery (Licence: MA 245415) | |
| 2085N0700X (Licence: MI 4301103992) | |
| Enumeration Date | 2010-08-31 |
| Last Update Date | 2025-11-12 |