| NPI | 1770912230 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OH 145069) |
| 246RP1900X Technician, Pathology Phlebotomy | |
| Enumeration Date | 2013-11-05 |
| Last Update Date | 2024-03-14 |