| NPI | 1114111622 |
|---|---|
| Former Name | TARA BETH CREEHAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 0000027103) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302039044) |
| 183500000X Pharmacist (Licence: PA RP441142) | |
| Enumeration Date | 2007-08-29 |
| Last Update Date | 2022-01-27 |