| NPI | 1770849408 |
|---|---|
| Former Name | STEPHANIE ANNE VINCENT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 68830) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 57133) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MN 57133) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: WI 68830) | |
| Enumeration Date | 2012-04-06 |
| Last Update Date | 2018-07-18 |