NPI | 1851400618 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: TX R3950) |
Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: TN 46299) |
2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD00047029) | |
Enumeration Date | 2006-08-29 |
Last Update Date | 2022-03-14 |