| NPI | 1053633172 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH60114432) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 20 052756) |
| Enumeration Date | 2010-02-16 |
| Last Update Date | 2010-02-16 |