| NPI | 1124531645 |
|---|---|
| Former Name | NICOLE PEREA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH60782161) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NM RP00008765) |
| Enumeration Date | 2017-11-06 |
| Last Update Date | 2021-03-31 |