| NPI | 1841986569 |
|---|---|
| Former Name | LISA DEITERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2014023127) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051298440) |
| Enumeration Date | 2023-04-14 |
| Last Update Date | 2023-04-14 |