NPI | 1164018479 |
---|---|
Former Name | WANDA CAROL COOK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 183500000X Pharmacist (Licence: MS E06619) |
Additional Taxonomies | 183500000X Pharmacist (Licence: OK R15569) |
183500000X Pharmacist (Licence: AL 18175) | |
183500000X Pharmacist (Licence: TN 36488) | |
183500000X Pharmacist (Licence: LA PST.020401) | |
Enumeration Date | 2020-12-21 |
Last Update Date | 2020-12-21 |