| NPI | 1831500339 |
|---|---|
| Former Name | MEGAN SUZANNE STAAKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: TX R6591) |
| Enumeration Date | 2014-05-19 |
| Last Update Date | 2020-10-07 |