| NPI | 1356097273 |
|---|---|
| Former Name | NICOLE ANDERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246RP1900X Technician, Pathology Phlebotomy |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: FL 516569) |
| Enumeration Date | 2022-03-01 |
| Last Update Date | 2022-03-05 |