| NPI | 1184738809 |
|---|---|
| Former Name | RENEE MASHELL MOMON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA 16149) |
| Additional Taxonomies | 1835N1003X Pharmacist, Nutrition Support (Licence: FL PS25295) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2007-07-08 |