| NPI | 1174630859 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WV RP0007025) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03127293) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2021-05-17 |