| NPI | 1487941613 |
|---|---|
| Former Name | LAURIE ANN JAGEMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH 60224725) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OR RPH-0012691) |
| Enumeration Date | 2011-07-08 |
| Last Update Date | 2013-04-15 |