| NPI | 1629158688 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: IA 38726) |
| Additional Taxonomies | 207ZB0001X Pathology, Blood Banking & Transfusion Medicine (Licence: IA 38726) |
| 208D00000X General Practice (Licence: IA 38726) | |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2020-11-17 |