NPI | 1720595440 |
---|---|
Former Name | JANE MADELEINE AXELROD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 183500000X Pharmacist (Licence: MN 123300) |
Additional Taxonomies | 1835P1300X Pharmacist, Psychiatric (Licence: MN 123300) |
Enumeration Date | 2018-01-03 |
Last Update Date | 2025-09-19 |