| 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 |