| NPI | 1669977575 |
|---|---|
| Former Name | STEPHANIE BLATCH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD61521437) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD d97790) |
| Enumeration Date | 2018-03-25 |
| Last Update Date | 2026-01-18 |