NPI | 1144566530 |
---|---|
Former Name | JAMIE LEA TRAUT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: KS 1-16341) |
Additional Taxonomies | 183500000X Pharmacist (Licence: MO 2011023093) |
183500000X Pharmacist (Licence: NE 13672) | |
Enumeration Date | 2012-12-12 |
Last Update Date | 2024-09-17 |