NPI | 1467569863 |
---|---|
Former Name | BROOK SMITH KAWCHAK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 183500000X Pharmacist (Licence: MI 5302034164) |
Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03-01-27524) |
Enumeration Date | 2006-08-23 |
Last Update Date | 2014-06-05 |