NPI | 1053547422 |
---|---|
Former Name | MELISSA SUE KEETON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: TN 33539) |
Additional Taxonomies | 183500000X Pharmacist (Licence: AL 14899) |
183500000X Pharmacist (Licence: MS 10475) | |
Enumeration Date | 2009-05-29 |
Last Update Date | 2009-05-29 |