| NPI | 1063008985 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 376J00000X Homemaker |
| Additional Taxonomies | 246RP1900X Technician, Pathology, Phlebotomy (Licence: MS 22-1648) |
| Enumeration Date | 2020-12-15 |
| Last Update Date | 2022-05-02 |