| NPI | 1316218738 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CO PHA.0021275) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD 20229) |
| 183500000X Pharmacist (Licence: PA RP445671) | |
| Enumeration Date | 2012-01-17 |
| Last Update Date | 2019-04-05 |