| NPI | 1912960857 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: MI 4301051288) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: OH 35059514H) |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2018-08-29 |