| NPI | 1962405456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: NV 11890) |
| Additional Taxonomies | 2085R0001X (Licence: WA MD61616345) |
| 2085R0203X Radiology, Therapeutic Radiology (Licence: CA G21590) | |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2025-03-06 |