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 |