| NPI | 1013553338 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: MI 5302044657) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: MI 5302044657) |
| Enumeration Date | 2019-11-21 |
| Last Update Date | 2019-11-26 |