| NPI | 1497318588 |
|---|---|
| Former Name | STEPHANIE NGUYEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: WA ML61059938) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2019-04-15 |
| Last Update Date | 2020-07-11 |