| NPI | 1376753038 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WV RP0006033) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03-3-25571) |
| 183500000X Pharmacist (Licence: NY 044448-1) | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2007-07-08 |