NPI | 1881005833 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2085P0229X Radiology Pediatric Radiology (Licence: WA MD61039865) |
Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: WA MD61039865) |
2085R0202X Radiology Diagnostic Radiology (Licence: MI 4301503485) | |
Enumeration Date | 2014-05-13 |
Last Update Date | 2025-01-22 |