NPI | 1316104888 |
---|---|
Former Name | AMANDA KAY MATZKE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OR DO156796) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2008-05-21 |
Last Update Date | 2013-05-29 |