| NPI | 1114244530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WV RP0007042) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03228337) |
| Enumeration Date | 2010-04-24 |
| Last Update Date | 2014-09-02 |