NPI | 1164601639 |
---|---|
Former Name | MICHELE LEE CARROLL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 333600000X Pharmacy (Licence: FL PS42312) |
Additional Taxonomies | 183500000X Pharmacist (Licence: FL ps42312) |
Enumeration Date | 2007-10-31 |
Last Update Date | 2022-12-19 |