| NPI | 1134655038 |
|---|---|
| Former Name | SARA ANN FREDERICKS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CO PHA.0016778) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NE 11861) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2017-05-11 |