| NPI | 1083045876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P1300X Pharmacist, Psychiatric (Licence: VA 0202205506) |
| Additional Taxonomies | 1835P1300X Pharmacist, Psychiatric (Licence: MA PH22646) |
| Enumeration Date | 2013-12-05 |
| Last Update Date | 2015-05-05 |