| NPI | 1740966787 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246RP1900X Technician, Pathology, Phlebotomy (Licence: FL 272260612) |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2023-06-26 |
| Last Update Date | 2024-06-12 |