| NPI | 1083860878 |
|---|---|
| Former Name | TRACY WALZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IN 26022788A) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03129734) |
| Enumeration Date | 2008-08-12 |
| Last Update Date | 2013-04-02 |