| NPI | 1477333441 |
|---|---|
| Former Name | ELIZABETH ANNE KAVANAUGH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 043951) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KS 1-17151) |
| Enumeration Date | 2023-10-05 |
| Last Update Date | 2023-10-05 |