NPI | 1760866396 |
---|---|
Former Name | TARA FEHRENBACH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03334469) |
Additional Taxonomies | 183500000X Pharmacist (Licence: KY 017731) |
Enumeration Date | 2015-07-14 |
Last Update Date | 2023-05-17 |