| NPI | 1801553599 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MD LP54912) |
| Additional Taxonomies | 246RP1900X Technician, Pathology, Phlebotomy (Licence: MD K2T9G7H8) |
| Enumeration Date | 2021-11-17 |
| Last Update Date | 2021-11-17 |