| NPI | 1659065472 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171W00000X Contractor |
| Additional Taxonomies | 246RP1900X Technician, Pathology, Phlebotomy (Licence: GA GA-13625-110122) |
| Enumeration Date | 2023-06-05 |
| Last Update Date | 2024-06-10 |