| NPI | 1790079176 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A125590) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 248582) | 
| 2085N0700X (Licence: CA A125590) | |
| Enumeration Date | 2011-06-03 | 
| Last Update Date | 2017-06-12 |