| NPI | 1063399038 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 333600000X Pharmacy (Licence: WA 61660564) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: WA 61660564) |
| Enumeration Date | 2025-08-20 |
| Last Update Date | 2025-09-01 |