| NPI | 1063728194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH00053203) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ S12329) |
| Enumeration Date | 2010-08-26 |
| Last Update Date | 2010-08-26 |