| NPI | 1063410876 |
|---|---|
| Former Name | DIANE KAY RYAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IL 051.291636) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP033124L) |
| Enumeration Date | 2005-07-14 |
| Last Update Date | 2013-04-17 |