| NPI | 1346851417 |
|---|---|
| Former Name | TATIANA BASTLOVA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 247ZC0005X Pathology, Clinical Laboratory Director, Non-physician (Licence: GA 20027SP) |
| Additional Taxonomies | 247ZC0005X Pathology, Clinical Laboratory Director, Non-physician |
| Enumeration Date | 2020-08-12 |
| Last Update Date | 2020-12-02 |