| NPI | 1285972273 |
|---|---|
| Former Name | HEATHER LYNN LUEDTKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WI 13261-40) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ S010722) |
| Enumeration Date | 2013-01-25 |
| Last Update Date | 2013-01-25 |