NPI | 1386243053 |
---|---|
Former Name | SHANNON LABOR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS47312) |
Additional Taxonomies | 183500000X Pharmacist (Licence: MO 2004031546) |
Enumeration Date | 2020-10-22 |
Last Update Date | 2020-10-22 |