| NPI | 1255786364 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WV RP0007049) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03334373) |
| Enumeration Date | 2016-04-26 |
| Last Update Date | 2016-04-26 |