| NPI | 1659758225 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CA 20A15642) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| Enumeration Date | 2015-05-02 |
| Last Update Date | 2022-10-11 |