NPI | 1053509943 |
---|---|
Former Name | BRENDA FAYE BURRISS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 246RP1900X Technician, Pathology, Phlebotomy (Licence: MD 36119494) |
Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
Enumeration Date | 2007-10-04 |
Last Update Date | 2022-07-21 |