| NPI | 1124113212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202004468) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WV RP0003356) |
| 183500000X Pharmacist (Licence: KY 011130) | |
| 183500000X Pharmacist (Licence: TN 0000034167) | |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2010-08-02 |