NPI | 1902869639 |
---|---|
Former Name | SHELLIE LIN CRAIG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD226278) |
Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: OR MD226278) |
2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TX J4245) | |
2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA C155476) | |
Enumeration Date | 2006-04-12 |
Last Update Date | 2025-08-07 |