| NPI | 1003437443 |
|---|---|
| Former Name | KAITLIN GIBSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 85172-20) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 125075723) |
| 207R00000X Internal Medicine (Licence: IL 125.075723) | |
| Enumeration Date | 2020-04-27 |
| Last Update Date | 2025-09-05 |