| NPI | 1902803604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: NJ MA 05137600) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: PA MD 043914-L) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2014-11-25 |