NPI | 1396074282 |
---|---|
Former Name | LAURA A MICKEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 183500000X Pharmacist (Licence: TX 43425) |
Additional Taxonomies | 183500000X Pharmacist (Licence: NE 12853) |
183500000X Pharmacist (Licence: IA 20821) | |
Enumeration Date | 2009-12-23 |
Last Update Date | 2009-12-23 |