| NPI | 1972101913 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246RP1900X Technician, Pathology, Phlebotomy |
| Additional Taxonomies | 246RP1900X Technician, Pathology, Phlebotomy |
| Enumeration Date | 2020-10-12 |
| Last Update Date | 2020-10-12 |