| NPI | 1902234511 |
|---|---|
| Former Name | JACLYN CHRISTINE SHAW |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: CA C186515) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: TN 55992) |
| 207ZP0101X Pathology, Anatomic Pathology (Licence: MA 255866) | |
| Enumeration Date | 2013-10-16 |
| Last Update Date | 2023-07-26 |