| NPI | 1972997773 |
|---|---|
| Former Name | COURTNEY BROOKE EDWARDS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KY 014214) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 25598) |
| Enumeration Date | 2015-03-19 |
| Last Update Date | 2016-09-13 |