Individual
MIN DAI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1501 KINGS HIGHWAY, PATHOLOGY, SHREVEPORT, LA 71130-3932
(318) 675-7822
Mailing address
1501 KINGS HIGHWAY, PATHOLOGY, SHREVEPORT, LA 71130-3932
(318) 675-7822
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/07/2020
Last updated
04/07/2020
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