| NPI | 1821441502 |
|---|---|
| Former Name | CRYSTAL HOSTETTER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WY 3466) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: SD 5923) |
| 183500000X Pharmacist (Licence: NE 13855) | |
| Enumeration Date | 2016-07-19 |
| Last Update Date | 2016-10-27 |