| NPI | 1073821567 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA 312969) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: LA 018294) |
| Enumeration Date | 2010-09-17 |
| Last Update Date | 2019-10-17 |