| NPI | 1922395284 |
|---|---|
| Former Name | JENNIFER N MCMICKEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP445721) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 063812) |
| Enumeration Date | 2011-07-06 |
| Last Update Date | 2019-05-06 |