| NPI | 1629166160 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: VA 0102201121) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: VA 0102201121) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2018-03-17 |