| NPI | 1124315882 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 42115) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 053918) |
| Enumeration Date | 2011-07-01 |
| Last Update Date | 2016-02-26 |