| NPI | 1760634984 |
|---|---|
| Former Name | GLORIA M MERCADO JIMENEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: PR 893) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: PR 09-F-0674) |
| Enumeration Date | 2008-10-21 |
| Last Update Date | 2008-10-21 |