| NPI | 1730110511 |
|---|---|
| Former Name | SUSAN ANN GONYOU |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WY 2396) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CO 11484) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2007-07-08 |