| NPI | 1811277304 |
|---|---|
| Former Name | LAURA MICHELLE STANFORD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AL 17602) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH026257) |
| Enumeration Date | 2011-08-28 |
| Last Update Date | 2015-01-17 |