| NPI | 1124634811 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 246RP1900X Technician, Pathology Phlebotomy |
| Enumeration Date | 2020-09-18 |
| Last Update Date | 2020-09-18 |