| NPI | 1083769822 |
|---|---|
| Former Name | TAMMY SUZANNE STAEHLER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WI 13629-040) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IA 19051) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2007-07-08 |