| NPI | 1164778916 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03132228) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KY 016187) |
| Enumeration Date | 2012-07-31 |
| Last Update Date | 2023-08-01 |