| NPI | 1568469963 |
|---|---|
| Former Name | STACEY WEBER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: UT 6553967-1701) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CO 15263) |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2011-03-17 |