| NPI | 1477193589 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY WALKER Provider Enrollment COO Rdinator 561-300-2410 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207ZP0007X Pathology Molecular Genetic Pathology |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| 207V00000X Obstetrics & Gynecology | |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology | |
| Enumeration Date | 2020-01-07 |
| Last Update Date | 2024-08-20 |