| NPI | 1972831949 |
|---|---|
| Former Name | CAROL A TABER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 42689) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 112883) |
| Enumeration Date | 2009-12-02 |
| Last Update Date | 2009-12-02 |