NPI | 1053669333 |
---|---|
Former Name | ALICE E REYNOLDS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 183500000X Pharmacist (Licence: OK 11181) |
Additional Taxonomies | 183500000X Pharmacist (Licence: NC 9238) |
Enumeration Date | 2012-08-17 |
Last Update Date | 2012-08-17 |