| NPI | 1932463114 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: PA OT018107)  | 
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 5101019669)  | 
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA OS019330)  | |
| Enumeration Date | 2012-07-02 | 
| Last Update Date | 2022-07-21 |