| NPI | 1063735462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 052782) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CO PHA-18365) |
| Enumeration Date | 2010-03-12 |
| Last Update Date | 2010-03-12 |