| NPI | 1295005890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IA 21201) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051-290098) |
| 183500000X Pharmacist (Licence: MI 5302038658) | |
| 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: IA 361924025) | |
| Enumeration Date | 2012-01-12 |
| Last Update Date | 2012-01-12 |