| NPI | 1063774073 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 29753) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 462636) |
| Enumeration Date | 2012-06-14 |
| Last Update Date | 2012-06-14 |