| NPI | 1700218716 |
|---|---|
| Former Name | MALLORY RAE YOUNG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VT 033.0096154) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TN 38315) |
| 183500000X Pharmacist (Licence: PA RP449945) | |
| Enumeration Date | 2013-07-31 |
| Last Update Date | 2023-08-22 |