| NPI | 1184260713 |
|---|---|
| Former Name | TATIANA VASILIEVNA MCCLEARY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: IN 26023521A) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IN 26023521a) |
| Enumeration Date | 2019-11-19 |
| Last Update Date | 2022-12-21 |