| NPI | 1407138290 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03322226) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP039184L) |
| Enumeration Date | 2011-09-16 |
| Last Update Date | 2021-04-14 |