| NPI | 1255762159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH 60394159) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 46036) |
| Enumeration Date | 2013-12-03 |
| Last Update Date | 2013-12-03 |