| NPI | 1851418990 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: MI 4301086245) |
| Additional Taxonomies | 2085P0229X Radiology Pediatric Radiology (Licence: MA 243125) |
| 2085P0229X Radiology Pediatric Radiology (Licence: MI 4301086245) | |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2022-07-21 |