| NPI | 1164683959 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: UT 6025574-1205) |
| Additional Taxonomies | 207ZP0213X Pathology, Pediatric Pathology (Licence: UT 6025574-1205) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: UT 60255741205) | |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2021-12-03 |