| NPI | 1063794097 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MA PH25616) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI02874800) |
| Enumeration Date | 2011-09-15 |
| Last Update Date | 2011-09-15 |