| NPI | 1184957433 |
|---|---|
| Former Name | MIRANDA ASHLEY LANE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202210317) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TN 33676) |
| 183500000X Pharmacist (Licence: MS E-010562) | |
| Enumeration Date | 2009-09-17 |
| Last Update Date | 2019-05-13 |