| NPI | 1124313218 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: UT 8437516-1205)  | 
| Additional Taxonomies | 207ZF0201X Pathology, Forensic Pathology (Licence: UT 8437516-1205)  | 
| 207ZP0101X Pathology, Anatomic Pathology (Licence: IL 036137822)  | |
| 282N00000X General Acute Care Hospital (Licence: UT 8437516-1205)  | |
| 282N00000X General Acute Care Hospital (Licence: SC 33780)  | |
| Enumeration Date | 2011-06-16 | 
| Last Update Date | 2021-11-23 |