| NPI | 1912267626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX R7124) |
| Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: TX BP30060011) |
| Enumeration Date | 2012-05-29 |
| Last Update Date | 2018-08-10 |