| NPI | 1194079772 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 056774) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 56774I) |
| Enumeration Date | 2012-11-02 |
| Last Update Date | 2012-11-02 |