| NPI | 1962754879 |
|---|---|
| Former Name | KATIE LYNN TRAYLOR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: WA PH60888232) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 24275) |
| 1835P2201X Pharmacist, Ambulatory Care (Licence: UT 9451468-8911) | |
| 1835P2201X Pharmacist, Ambulatory Care (Licence: UT 9451468-1701) | |
| Enumeration Date | 2012-10-03 |
| Last Update Date | 2019-09-16 |