NPI | 1174055768 |
---|---|
Former Name | RACHAEL LYNN WINTERMUTE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 183500000X Pharmacist (Licence: ID P9753) |
Additional Taxonomies | 183500000X Pharmacist (Licence: WA PH60751105) |
Enumeration Date | 2017-04-01 |
Last Update Date | 2022-02-15 |