| NPI | 1356889117 |
|---|---|
| Former Name | KATELYN THERESA VAUTRIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MA PH235900) |
| Additional Taxonomies | 1835P2201X Pharmacist, Ambulatory Care (Licence: MA PH235900) |
| Enumeration Date | 2017-02-01 |
| Last Update Date | 2018-11-30 |