| NPI | 1902123011 |
|---|---|
| Professional Name | MARJORIE JACK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 12055) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03114801) |
| Enumeration Date | 2010-04-28 |
| Last Update Date | 2010-04-28 |