| NPI | 1538825054 |
|---|---|
| Former Name | TRAVICIA BROWN LAKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 247ZC0005X Pathology, Clinical Laboratory Director, Non-physician |
| Additional Taxonomies | 246RM2200X Technician, Pathology, Medical Laboratory |
| 3747A0650X Technician, Attendant Care Provider | |
| Enumeration Date | 2021-11-09 |
| Last Update Date | 2022-06-02 |