| NPI | 1104991157 |
|---|---|
| Former Name | THERESA ANN RUEHLOW |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WI 13112-040) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CO 15686) |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2007-07-08 |