| NPI | 1639699465 |
|---|---|
| Former Name | LAURA ASHLYN BROOME |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 21072) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TN 36149) |
| 183500000X Pharmacist (Licence: CT 0013225) | |
| Enumeration Date | 2017-06-22 |
| Last Update Date | 2017-10-12 |