NPI | 1073066544 |
---|---|
Former Name | SHELBY ANN BENNETT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 183500000X Pharmacist (Licence: NE 16681) |
Additional Taxonomies | 183500000X Pharmacist (Licence: MO 2016030998) |
1835P2201X Pharmacist, Ambulatory Care (Licence: NE 16681) | |
183500000X Pharmacist (Licence: IA 23010) | |
183500000X Pharmacist (Licence: KS 1-100585) | |
Enumeration Date | 2016-08-01 |
Last Update Date | 2024-01-09 |