| NPI | 1871821413 |
|---|---|
| Former Name | LISA JOY KELLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WI 14761-040) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 118724) |
| 183500000X Pharmacist (Licence: IA 23266) | |
| Enumeration Date | 2009-11-19 |
| Last Update Date | 2021-01-14 |