| NPI | 1659785152 |
|---|---|
| Former Name | JESSICA LEE DAVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835C0207X Pharmacist, Compounded Sterile Preparations (Licence: KY 016674) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03232903) |
| 183500000X Pharmacist (Licence: KY 016674) | |
| Enumeration Date | 2014-06-12 |
| Last Update Date | 2025-08-15 |