| NPI | 1891021424 |
|---|---|
| Former Name | CAROLYN MARIE FAUSER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OK 14432) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 15045) |
| 183500000X Pharmacist (Licence: TX 39502) | |
| Enumeration Date | 2009-11-02 |
| Last Update Date | 2019-03-29 |