| NPI | 1366840928 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH 60510397) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 54922) |
| Enumeration Date | 2014-12-15 |
| Last Update Date | 2014-12-15 |