| NPI | 1104107838 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 0000008424) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TN 8424) |
| Enumeration Date | 2011-09-08 |
| Last Update Date | 2016-06-21 |