NPI | 1265724363 |
---|---|
Former Name | LANA M NICOLARSEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 183500000X Pharmacist (Licence: NC 21604) |
Additional Taxonomies | 183500000X Pharmacist (Licence: CO 18813) |
Enumeration Date | 2011-05-07 |
Last Update Date | 2014-07-17 |