| NPI | 1023207222 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: TN 24432) |
| Additional Taxonomies | 1835P2201X Pharmacist, Ambulatory Care (Licence: KY 012921) |
| Enumeration Date | 2007-10-24 |
| Last Update Date | 2017-12-27 |