| 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 |