| NPI | 1154992683 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: TX 68917) |
| Additional Taxonomies | 1835P2201X Pharmacist, Ambulatory Care (Licence: VA 0202218873) |
| Enumeration Date | 2021-07-06 |
| Last Update Date | 2022-09-22 |