| NPI | 1922196708 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 3559) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: AZ 3559) | |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2021-09-02 |