| NPI | 1104420413 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI03255200) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KY 012503) |
| Enumeration Date | 2020-11-27 |
| Last Update Date | 2020-11-27 |