| NPI | 1861833246 |
|---|---|
| Former Name | JESSICA RENEE ROUNSEVILLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P1300X Pharmacist Psychiatric (Licence: NY 058050-I) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 058050) |
| Enumeration Date | 2013-07-12 |
| Last Update Date | 2020-03-11 |