NPI | 1609164227 |
---|---|
Former Name | DEIDRA FAWN NAYLOR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: WV 21489) |
Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: SC 21492) |
Enumeration Date | 2011-07-17 |
Last Update Date | 2011-07-17 |