| NPI | 1164775367 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MA PH233927) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NH R3124) |
| Enumeration Date | 2012-10-25 |
| Last Update Date | 2022-09-19 |