| NPI | 1104031160 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: UT 6444355-1701) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03326826) |
| Enumeration Date | 2007-05-13 |
| Last Update Date | 2007-07-08 |