| NPI | 1053619783 |
|---|---|
| Former Name | AMANDA ERIN JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 40741) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 21594) |
| Enumeration Date | 2011-03-03 |
| Last Update Date | 2020-11-20 |