NPI | 1053899419 |
---|---|
Former Name | CASSAUNDRA S GROOMS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03236832) |
Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202216254) |
Enumeration Date | 2018-07-29 |
Last Update Date | 2018-07-29 |