| NPI | 1104110352 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 63596) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WI 15826-40) |
| 183500000X Pharmacist (Licence: AZ S019768) | |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2016-04-21 |