| NPI | 1992906556 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX N6491) | 
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301083349) | 
| Enumeration Date | 2007-05-30 | 
| Last Update Date | 2018-05-15 |