| NPI | 1366565319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH00068294) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 118392) |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2007-07-09 |