| NPI | 1063944726 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: ID P6493) |
| Additional Taxonomies | 1835P2201X Pharmacist, Ambulatory Care (Licence: WA PH00039410) |
| Enumeration Date | 2017-03-31 |
| Last Update Date | 2017-03-31 |