| NPI | 1376915710 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 062666I) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VT 033.0086725) |
| Enumeration Date | 2015-10-26 |
| Last Update Date | 2022-07-21 |