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Individual
LACANDIAN SPENCER
Active
Individual
LACANDIAN SPENCER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.D.
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PD11795
AR
Other
Enumeration date
11/28/2012
Last updated
02/26/2015
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