| NPI | 1083999296 |
|---|---|
| Former Name | KARLIE MICHELLE DOUGLAS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KY 014783) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IA 20884) |
| 183500000X Pharmacist (Licence: MN 117421) | |
| Enumeration Date | 2011-10-19 |
| Last Update Date | 2011-10-19 |