NPI | 1639517535 |
---|---|
Former Name | THERESA IRENE DALTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NE 27808) |
Additional Taxonomies | 208D00000X General Practice (Licence: NE 27808) |
Enumeration Date | 2013-06-13 |
Last Update Date | 2024-07-22 |