| NPI | 1952705527 |
|---|---|
| Former Name | KEISHA LATRICE RAPP |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: LA 018416) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 52541) |
| Enumeration Date | 2014-10-10 |
| Last Update Date | 2014-10-10 |