NPI | 1942578125 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: KY 56622) |
Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: NC 2022-02984) |
2085P0229X Radiology, Pediatric Radiology (Licence: TX K5896) | |
2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME146037) | |
Enumeration Date | 2011-12-02 |
Last Update Date | 2023-12-13 |