| NPI | 1215053004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P1200X Pharmacist Pharmacotherapy (Licence: MI 5302034354) |
| Additional Taxonomies | 1835P1200X Pharmacist Pharmacotherapy (Licence: KY 011988) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2007-07-08 |