| NPI | 1053542688 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MA PH235041) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 052975) |
| Enumeration Date | 2009-07-30 |
| Last Update Date | 2024-08-29 |