| NPI | 1124431770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 57865) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KY 016675) |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2019-01-02 |