| NPI | 1275837940 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH60028504) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD 18046) |
| Enumeration Date | 2011-01-10 |
| Last Update Date | 2011-01-10 |