| 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 |