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 |