| NPI | 1093128803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY I058010-1) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 58010) |
| Enumeration Date | 2014-06-09 |
| Last Update Date | 2020-08-17 |