| NPI | 1861086332 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIVINE TANYIATEM NSOESIE Owner/CEO 240-604-0984 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246RP1900X Technician, Pathology, Phlebotomy |
| Enumeration Date | 2021-02-25 |
| Last Update Date | 2021-03-12 |