| NPI | 1104907203 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WY 2873) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NE 11719) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2007-07-08 |