| NPI | 1073078713 |
|---|---|
| Former Name | BROOKE DEE HAVLAT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NE 16117) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IA 23461) |
| Enumeration Date | 2019-02-06 |
| Last Update Date | 2020-05-06 |