| NPI | 1225309867 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246RP1900X Technician, Pathology, Phlebotomy (Licence: FL 10606-cpt11) |
| Additional Taxonomies | 302F00000X Exclusive Provider Organization |
| Enumeration Date | 2012-01-12 |
| Last Update Date | 2023-10-19 |