| NPI | 1003597444 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 333600000X Pharmacy (Licence: NJ 28RI04279100) |
| Additional Taxonomies | 333600000X Pharmacy (Licence: NY 053202) |
| Enumeration Date | 2023-07-28 |
| Last Update Date | 2023-07-28 |