| NPI | 1205212842 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 060470) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 56820) |
| Enumeration Date | 2015-08-05 |
| Last Update Date | 2015-08-05 |