| NPI | 1255004768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03440830) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WV RP0012703) |
| 183500000X Pharmacist (Licence: WA PH61295213) | |
| Enumeration Date | 2021-07-29 |
| Last Update Date | 2023-12-27 |