NPI | 1134683402 |
---|---|
Former Name | ABIGAIL SURLES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: KY 017862) |
Additional Taxonomies | 1835P2201X Pharmacist, Ambulatory Care (Licence: KY 6151339) |
Enumeration Date | 2019-01-30 |
Last Update Date | 2019-02-28 |