| NPI | 1104205582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH60525531) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NV 18588) |
| Enumeration Date | 2015-05-19 |
| Last Update Date | 2015-05-19 |