| NPI | 1225003577 |
|---|---|
| Former Name | LATONIA EVETTE ROACH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: IN 01057585A) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX N8357) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TN 46379) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MN telemedicine 1616) | |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2013-01-02 |