| NPI | 1780810606 |
|---|---|
| Former Name | KRISTEN MYRTLE WIKHOLM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A130814) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: MN 25161) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 25161) | |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: MN 25161) | |
| Enumeration Date | 2009-06-05 |
| Last Update Date | 2014-11-11 |