| NPI | 1346247806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 333600000X Pharmacy (Licence: MO 2001023389) |
| Additional Taxonomies | 1835P1300X Pharmacist, Psychiatric (Licence: MO 2001023389) |
| 1835P1300X Pharmacist, Psychiatric (Licence: GA RPH021923) | |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2012-08-21 |