| NPI | 1558896126 |
|---|---|
| Former Name | SHELBY NICOLE ANDERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NY 328897) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: SC DO87950) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 328897) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: SC DO87950) | |
| Enumeration Date | 2017-04-20 |
| Last Update Date | 2024-05-22 |