NPI | 1972827681 |
---|---|
Former Name | KELLY ANN WILLIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: LA MD.206813) |
Enumeration Date | 2010-03-24 |
Last Update Date | 2022-07-21 |