| NPI | 1629239025 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: NY 269685) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NY 269685) |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2021-08-09 |