NPI | 1912295676 |
---|---|
Former Name | MARQUITA D BRADSHAW |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: GA RPH025742) |
Additional Taxonomies | 183500000X Pharmacist (Licence: OK 14933) |
Enumeration Date | 2011-07-15 |
Last Update Date | 2016-07-05 |