| NPI | 1104158534 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: NY 32465) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: CT 7102) |
| Enumeration Date | 2010-02-10 |
| Last Update Date | 2010-02-10 |