| NPI | 1316255086 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03228274) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202208789) |
| 183500000X Pharmacist (Licence: NC 20757) | |
| Enumeration Date | 2010-09-15 |
| Last Update Date | 2022-09-01 |