| NPI | 1285159202 |
|---|---|
| Former Name | SHEA ALEXA LIPUT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MN 123825) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03135452) |
| Enumeration Date | 2017-08-10 |
| Last Update Date | 2021-05-24 |