NPI | 1396343034 |
---|---|
Former Name | BRYNNA NELSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: WI 19474-40) |
Additional Taxonomies | 183500000X Pharmacist (Licence: MN 124182) |
Enumeration Date | 2020-10-14 |
Last Update Date | 2020-10-14 |