| NPI | 1104779925 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246Q00000X Spec/Tech, Pathology |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2026-02-19 |
| Last Update Date | 2026-02-19 |