| NPI | 1982662508 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 42075) |
| Additional Taxonomies | 2085N0700X (Licence: KY 54774) |
| 2085N0700X (Licence: PA MD466201) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 159497) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 54774) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD466201) | |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2021-01-28 |