NPI | 1437634912 |
---|---|
Former Name | BROOKE LYNN JOHNSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 246Q00000X Spec/Tech, Pathology (Licence: CA 31961) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: SC 6698) |
Enumeration Date | 2018-10-01 |
Last Update Date | 2021-07-13 |