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Individual

ANN MARY ISACC

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS,PHARM D,BCPS,CGP

Taxonomy

Speciality
Code
Description
License number
State
1835G0303X
Geriatric Pharmacist
15324-40
WI
1835P1200X
Pharmacotherapy Pharmacist
Primary
15324-40
WI

Other

Enumeration date
05/09/2014
Last updated
05/20/2014
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