| NPI | 1417569930 |
|---|---|
| Former Name | CARISSA HURT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KS 1-13528) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 2007023329) |
| 183500000X Pharmacist (Licence: OK 13480) | |
| Enumeration Date | 2020-08-17 |
| Last Update Date | 2020-08-17 |