| NPI | 1053061929 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CA 190559) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA A190559) |
| Enumeration Date | 2022-03-24 |
| Last Update Date | 2025-03-30 |