| NPI | 1407106750 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1300X Pharmacist, Psychiatric (Licence: TX 49056) |
| Additional Taxonomies | 1835P1300X Pharmacist, Psychiatric (Licence: KY 014927) |
| Enumeration Date | 2012-09-13 |
| Last Update Date | 2012-09-13 |