Individual
NWE NWE SOE
Active
Individual
NWE NWE SOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MBBS PHD D(ABHI)
Taxonomy
Speciality
Code
Description
License number
State
207ZC0006X
Clinical Pathology Physician
Primary
MTR02004425
CA
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
DI51072
FL
247ZC0005X
Clinical Laboratory Director (Non-physician)
DI51072
FL
Other
Enumeration date
03/04/2020
Last updated
07/09/2025
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