| NPI | 1043560964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03132102) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 22908) |
| Enumeration Date | 2012-09-18 |
| Last Update Date | 2021-01-20 |