| NPI | 1003311382 |
|---|---|
| Former Name | HALEY MELISSE SWANSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MD D0100044) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2024-06-26 |