| NPI | 1801890850 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: WA MD00030894) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: OR MD19047) |
| Enumeration Date | 2005-06-08 |
| Last Update Date | 2012-08-30 |