| NPI | 1104147271 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 045961) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VT 0333693) |
| Enumeration Date | 2010-06-11 |
| Last Update Date | 2012-02-16 |