| NPI | 1821371493 |
|---|---|
| Former Name | TASSIE JO SOUHRADA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA ph60165830) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ID p6449) |
| 183500000X Pharmacist (Licence: NJ 28RI03420500) | |
| 183500000X Pharmacist (Licence: MT 6312) | |
| Enumeration Date | 2011-09-21 |
| Last Update Date | 2024-05-06 |