NPI | 1801131107 |
---|---|
Former Name | ANN MARIE WIESNER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: NC 700275) |
Additional Taxonomies | 1835P2201X Pharmacist, Ambulatory Care (Licence: NC 25719) |
1835P2201X Pharmacist, Ambulatory Care (Licence: KY 013773) | |
1835P2201X Pharmacist, Ambulatory Care (Licence: VA 0202209615) | |
Enumeration Date | 2012-11-28 |
Last Update Date | 2021-04-09 |