| NPI | 1184139180 |
|---|---|
| Former Name | CLARISSA M HENDERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS65749) |
| Additional Taxonomies | 183700000X Pharmacy Technician (Licence: FL 27673) |
| Enumeration Date | 2017-12-13 |
| Last Update Date | 2023-07-27 |