| NPI | 1043652597 |
|---|---|
| Former Name | COURTNEY DANIELLE JASON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1300X Pharmacist Psychiatric (Licence: TX 53329) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 53329) |
| Enumeration Date | 2013-07-25 |
| Last Update Date | 2023-10-17 |