| NPI | 1053695759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MA 22652) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CO 15000) |
| Enumeration Date | 2011-09-29 |
| Last Update Date | 2021-05-19 |