| NPI | 1235483645 |
|---|---|
| Former Name | ELIZABETH MARY RUSSELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MA PH234500) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ME PR6103) |
| Enumeration Date | 2012-11-07 |
| Last Update Date | 2024-05-15 |