NPI | 1699967182 |
---|---|
Former Name | SHALONIE ROCHELLE MOORE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: SC 11661) |
Additional Taxonomies | 183500000X Pharmacist (Licence: MD 18433) |
183500000X Pharmacist (Licence: SC 11661) | |
183500000X Pharmacist (Licence: VA 0202207612) | |
Enumeration Date | 2007-08-17 |
Last Update Date | 2016-07-01 |