| NPI | 1023315264 |
|---|---|
| Former Name | ANGELA JEANINE DICKS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 10944) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 17532) |
| Enumeration Date | 2011-02-24 |
| Last Update Date | 2016-10-22 |