| NPI | 1821222639 |
|---|---|
| Former Name | DANIELLE LE DETLEFSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183700000X Pharmacy Technician (Licence: MN 703850) |
| Additional Taxonomies | 183700000X Pharmacy Technician (Licence: MN 4201-0107-1252-411) |
| Enumeration Date | 2009-05-07 |
| Last Update Date | 2009-05-07 |