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 |