| NPI | 1770903056 |
|---|---|
| Former Name | TIFFANY NICOLE TELARICO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: AR E11011) |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2014-04-24 |
| Last Update Date | 2019-06-07 |