| NPI | 1609998087 |
|---|---|
| Former Name | ELAINE WATSON FOSMIRE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH60552395) |
| Additional Taxonomies | 183700000X Pharmacy Technician (Licence: WA VA00065427) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2016-01-26 |