| NPI | 1609392224 |
|---|---|
| Former Name | KAYLA MARIE MUMAW |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP455344) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ S022972) |
| Enumeration Date | 2017-08-15 |
| Last Update Date | 2023-01-11 |