| NPI | 1952679730 |
|---|---|
| Former Name | KIMBERLY MODENA LUETTGERODT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: OR RPH-0012712) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WA PH-60283832) |
| 183500000X Pharmacist (Licence: OR RPH-0012712) | |
| 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: WA PH60283832) | |
| Enumeration Date | 2011-12-07 |
| Last Update Date | 2026-01-07 |