| NPI | 1164265443 |
|---|---|
| Former Name | MARY MARGARET MCCLELLAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 33087) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NV 7518) |
| Enumeration Date | 2024-06-14 |
| Last Update Date | 2024-06-14 |