| NPI | 1346607199 |
|---|---|
| Former Name | KELSEY SUZANNE CARTER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2012023887) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KS 1-112226) |
| Enumeration Date | 2016-01-25 |
| Last Update Date | 2022-06-07 |