| NPI | 1396036257 |
|---|---|
| Former Name | MIGNON TALA SCHLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202207671) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD 20080) |
| Enumeration Date | 2011-04-27 |
| Last Update Date | 2011-04-27 |