| 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 |