| NPI | 1548762941 |
|---|---|
| Former Name | BECKY JANE FULIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: CA 66196) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 66196) |
| 183500000X Pharmacist (Licence: TX 47711) | |
| Enumeration Date | 2018-03-02 |
| Last Update Date | 2018-03-02 |