| NPI | 1376923516 |
|---|---|
| Former Name | KATHLEEN CRYSTAL ALYCIA WEBER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology Anatomic Pathology (Licence: MI 4301116468) |
| Enumeration Date | 2015-06-03 |
| Last Update Date | 2020-08-14 |