| NPI | 1093067449 |
|---|---|
| Former Name | ELIZABETH ANN SLAGLE |
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MT 7915) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 43052) |
| Enumeration Date | 2012-10-10 |
| Last Update Date | 2012-10-10 |