| NPI | 1619551850 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: GA lpn064789) |
| Additional Taxonomies | 247ZC0005X Pathology, Clinical Laboratory Director, Non-physician |
| 251E00000X Home Health (Licence: GA lpn064789) | |
| 291U00000X Clinical Medical Laboratory | |
| Enumeration Date | 2021-05-12 |
| Last Update Date | 2021-05-12 |