| NPI | 1487178786 |
|---|---|
| Former Name | STACEY MARIE SPRAGUE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: MI 5302414596) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 27224) |
| Enumeration Date | 2017-07-28 |
| Last Update Date | 2024-05-22 |