| NPI | 1942557459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX Q0839) |
| Additional Taxonomies | 208D00000X General Practice (Licence: TX Q0839) |
| Enumeration Date | 2012-08-14 |
| Last Update Date | 2015-05-24 |