| NPI | 1790710457 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: AZ 005384) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: OH 34.007902) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: CA 20A9404) | |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2013-08-14 |