| NPI | 1104853407 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 14416) |
| Additional Taxonomies | 1835N1003X Pharmacist, Nutrition Support (Licence: MD 14416) |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: MD 14416) | |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2007-07-08 |