| NPI | 1336161611 |
|---|---|
| Former Name | PEGGY JEAN BRICHACEK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OK 7863) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 027724) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2007-07-08 |