| NPI | 1356757306 |
|---|---|
| Former Name | CRYSTAL COLEMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 35388) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 23758) |
| Enumeration Date | 2014-07-09 |
| Last Update Date | 2014-07-09 |