| NPI | 1881191351 |
|---|---|
| Former Name | CRYSTA BOPHA IV |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085B0100X Radiology, Body Imaging (Licence: NC 202400563) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301504743) |
| Enumeration Date | 2018-04-10 |
| Last Update Date | 2024-03-21 |