NPI | 1710356456 |
---|---|
Other Name | TESSIE DALLAS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 246QM0706X Spec/Tech, Pathology, Medical Technologist (Licence: SC MT 179117) |
Additional Taxonomies | 246QM0706X Spec/Tech, Pathology, Medical Technologist (Licence: NC HEW 44060069) |
246QM0706X Spec/Tech, Pathology, Medical Technologist (Licence: LA 201342.GEN) | |
Enumeration Date | 2015-09-23 |
Last Update Date | 2015-09-23 |