| NPI | 1578162756 |
|---|---|
| Former Name | JENNA ELIZABETH GRAGO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835C0205X Pharmacist, Critical Care (Licence: SC 42479) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 28820) |
| 183500000X Pharmacist (Licence: SC 42479) | |
| 183500000X Pharmacist (Licence: FL PS62452) | |
| Enumeration Date | 2020-10-20 |
| Last Update Date | 2022-04-04 |