| NPI | 1851931273 |
|---|---|
| Former Name | LAUREN ELIZABETH WAGNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ID P9217) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WA 60844796) |
| Enumeration Date | 2020-01-14 |
| Last Update Date | 2021-11-09 |