| NPI | 1376973495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 048962 DUP) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302036569) |
| Enumeration Date | 2013-11-26 |
| Last Update Date | 2013-11-26 |