| NPI | 1114502069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 146N00000X Emergency Medical Technician, Basic (Licence: VA B111376006) |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory (Licence: TX 45D2253313) |
| Enumeration Date | 2021-03-12 |
| Last Update Date | 2022-03-09 |