| NPI | 1104220235 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CO PHA.0020576) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CO 0020576) |
| 183500000X Pharmacist (Licence: MN 117440) | |
| 183500000X Pharmacist (Licence: SD 4410) | |
| Enumeration Date | 2014-10-17 |
| Last Update Date | 2024-04-11 |