| NPI | 1508896234 |
|---|---|
| Former Name | SUSANNE LYNN NOWAK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ 11464) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051.041013) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2007-07-08 |