| NPI | 1841411253 |
|---|---|
| Former Name | KELLY ANN MATHEWS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ 15448) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WA PH00021776) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2007-07-08 |