| NPI | 1063567915 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ 14313) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WA 55981) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2007-07-08 |