| NPI | 1992250252 |
|---|---|
| Former Name | RANDI MASON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246QB0000X Spec/Tech, Pathology, Blood Banking (Licence: NV 45151-TS-0) |
| Additional Taxonomies | 246QB0000X Spec/Tech, Pathology, Blood Banking (Licence: UT 3137) |
| Enumeration Date | 2016-08-16 |
| Last Update Date | 2016-08-16 |