| NPI | 1538161955 |
|---|---|
| Former Name | JACINTHA MARIE STALL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH00057767) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS30611) |
| 1835P1300X Pharmacist, Psychiatric (Licence: DC 298117) | |
| Enumeration Date | 2005-08-15 |
| Last Update Date | 2009-09-21 |