| NPI | 1225434483 |
|---|---|
| Former Name | KELLY MOTT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 59153) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: LA PST.020851) |
| Enumeration Date | 2014-11-14 |
| Last Update Date | 2025-02-11 |