| NPI | 1376654111 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP032322L) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CO 12721) |
| 183500000X Pharmacist (Licence: TX 30636) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2007-07-08 |